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Individual

JACQUELINE BUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT, BC-TMH

Contact information

Practice address
227 W 4TH ST STE 321, CHARLOTTE, NC 28202-1545
(704) 879-1179
(704) 490-4274
Mailing address
PO BOX 82406, BATON ROUGE, LA 70884-2406
(704) 879-1179
(704) 490-4274

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
106H00000X
Marriage & Family Therapist
0717002128
VA
106H00000X
Marriage & Family Therapist
206218
TX
106H00000X
Marriage & Family Therapist
Primary
2118
NC
106H00000X
Marriage & Family Therapist
7054
SC
106H00000X
Marriage & Family Therapist
LCM1108
MD
106H00000X
Marriage & Family Therapist
LMFT200001420
DC
106H00000X
Marriage & Family Therapist
MFT002250
GA
106H00000X
Marriage & Family Therapist
MFT1586
LA
106H00000X
Marriage & Family Therapist
TPMF251
FL

Other

Enumeration date
02/08/2018
Last updated
03/04/2026
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