Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PS003877-L | PA |
N | 103T00000X | Psychologist | PS003877-L | PA |
N | 103TA0700X | Adult Development & Aging Psychologist | PS003877-L | PA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PS003877-L | PA |
N | 103G00000X | Clinical Psychologist | PS003877-L | PA |
N | 103TC0700X | Clinical Psychologist | PS003877-L | PA |
N | 103TC1900X | Counseling Psychologist | PS003877-L | PA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PS003877-L | PA |
N | 103TF0000X | Family Psychologist | PS003877-L | PA |
N | 103TF0200X | Forensic Psychologist | PS003877-L | PA |
N | 103TM1800X | Intellectual & Developmental Disabilities | PS003877-L | PA |
N | 103TP2701X | Group Psychotherapist | PS003877-L | PA |
N | 103TS0200X | School Psychologist | PS003877-L | PA |
NPI | 1205891520 |
---|---|
Provider Name | Dr. William Earl Bush |
First Address | New Kensington, PA 15068-6014 |
Second Address | New Kensington, PA 15068-6014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
199034 | HIGHMARK INDIVIDUAL NUMBE (01) | PA |
279824 | VALUE OPTIONS INDIVIDUAL (01) | PA |
319828 | VALUE OPTIONS GROUP NUMBE (01) | PA |
C31948 | (02) | PA |