Basic Information
Provider Information
NPI: 1801533070
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUSHEY
FirstName: RACHEL
MiddleName:  
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Credential:  
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Mailing Information
Address1: 762 HERITAGE LN W
Address2:  
City: TERRE HAUTE
State: IN
PostalCode: 478031387
CountryCode: US
TelephoneNumber: 7813661852
FaxNumber:  
Practice Location
Address1: 6655 E US HIGHWAY 36
Address2:  
City: AVON
State: IN
PostalCode: 461238923
CountryCode: US
TelephoneNumber: 8887141927
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/18/2022
LastUpdateDate: 05/18/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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