Provider Demographics
NPI:1184382921
Name:BUSH, DENISE MARGARET (LPC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARGARET
Last Name:BUSH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 W SAINT MARYS RD STE 115
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-2655
Mailing Address - Country:US
Mailing Address - Phone:520-879-5665
Mailing Address - Fax:520-207-6409
Practice Address - Street 1:1775 W SAINT MARYS RD STE 115
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2655
Practice Address - Country:US
Practice Address - Phone:520-879-5665
Practice Address - Fax:520-207-6409
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-20040101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional