Individual
DIANE MARIE BUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC, LPCC, NCC
Contact information
Practice address
105 DAVENTRY LN STE 200, LOUISVILLE, KY 40223-3874
(502) 510-3947
Mailing address
5704 FRUITWOOD DR, LOUISVILLE, KY 40272-5018
(502) 510-3947
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
164184
KY
101YM0800X
Mental Health Counselor
Primary
264319
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100818890
—
KY
Enumeration date
01/14/2021
Last updated
03/25/2024
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