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Individual
MR. PERNELL M.J BUSH
Active
Individual
MR. PERNELL M.J BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW18109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1099907
OPTUM
FL
01
—
5845848
CIGNA
FL
01
—
601535783
MEGELLAN
FL
01
—
6157870
AETNA
FL
01
—
OH308
MEDICARE
FL
01
—
WMRMF
BCBS
FL
Enumeration date
01/29/2018
Last updated
05/16/2024
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