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Individual

MRS. CRYSTAL DENEE BUSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, LCAS, LISW-CP

Contact information

Practice address
2933 S MIAMI BLVD STE 101, DURHAM, NC 27703-9041
(984) 292-4235
(888) 245-5107
Mailing address
2933 S MIAMI BLVD STE 101, DURHAM, NC 27703-9041
(984) 292-4235
(888) 245-5107

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1615
NC
1041C0700X
Clinical Social Worker
Primary
C006358
NC
1041C0700X
Clinical Social Worker
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
156NM
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC
05
6007277
NC
01
SS#
TRICARE
NC
Enumeration date
09/25/2006
Last updated
08/08/2025
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