Provider Demographics
NPI:1447513429
Name:BUSH, HELEN V (MSW)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:V
Last Name:BUSH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 SW 27TH TER
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7913
Mailing Address - Country:US
Mailing Address - Phone:561-736-1340
Mailing Address - Fax:561-737-8194
Practice Address - Street 1:1515 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1911
Practice Address - Country:US
Practice Address - Phone:561-736-1340
Practice Address - Fax:561-737-8194
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-24
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSWF13591041C0700X
FLMFT827106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist