Provider Demographics
NPI:1568603694
Name:BUSHING, ANDREW SCOTT (CASAC)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:SCOTT
Last Name:BUSHING
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 W 15TH ST
Mailing Address - Street 2:#2RW
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6721
Mailing Address - Country:US
Mailing Address - Phone:646-391-8330
Mailing Address - Fax:
Practice Address - Street 1:16 WESTCHESTER SQ
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3513
Practice Address - Country:US
Practice Address - Phone:718-518-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21444101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)