Provider Demographics
NPI:1831244334
Name:BUSH, RACHEL (DNP, PMHNP-BC, LPC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:
Last Name:BUSH
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MALLET HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-3223
Mailing Address - Country:US
Mailing Address - Phone:803-479-1724
Mailing Address - Fax:803-844-7151
Practice Address - Street 1:117 ALPINE CIR STE 600
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223
Practice Address - Country:US
Practice Address - Phone:803-479-1724
Practice Address - Fax:803-844-7151
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4910101YP2500X
SC24738363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional