Individual
MARK ALAN BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
150 E MARKET ST, WARREN, OH 44481-1141
(330) 399-6451
(330) 394-6266
Mailing address
3535 DARBYSHIRE DR, CANFIELD, OH 44406-9233
(330) 270-5710
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C0005242
OH
101YP2500X
Professional Counselor
Primary
C.0005242
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000125439
ANTHEM PIN #
OH
01
—
733387000
MAGELLAN PIN#
OH
Enumeration date
01/16/2007
Last updated
12/13/2024
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