DR. MARY LU BUSHNELL (NPI# 1861687360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861687360 |
| Entity Type | Individual |
| Full Name | DR. MARY LU BUSHNELL |
| Other Name | MISS MARY LU WYLIE |
| Credential | PSY.D. |
| Practice Address |
650 E Indian School Rd # 116b Phoenix AZ 85012-1839 |
| Practice Telephone | 6022775551 |
| Mailing Telephone | 6022775551 |
| Enumeration Date | 2007-09-09 |
| Last Update Date | 2007-09-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 3900 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174130470 | Mary Lelia Bushnell | Case Manager/Care Coordinator | 905 E 7th Ave Ste 2, Oakdale, LA 71463-2788 | 2020-09-30 |
| 1336287085 | Mary K Bushnell | Nurse Practitioner | 2415 Se 43rd Ave, Suite 100, Portland, OR 97206-1600 | 2007-02-02 |
| Street Address |
650 E INDIAN SCHOOL RD # 116B |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467088062 | Generational Bridges Neuropsychological Services Pllc | Clinical Neuropsychologist | 1515 E Missouri Dr, Phoenix, AZ 85014 | 2020-03-16 |
| 1750862264 | Focus Neuropsychology Az, Pllc | Clinical Neuropsychologist | 2400 N Central Ave Ste 204, Phoenix, AZ 85004-1341 | 2018-08-22 |
| 1386172732 | Brett Andersen | Clinical Neuropsychologist | 300 W Clarendon Ave Ste 130, Phoenix, AZ 85013-3421 | 2017-05-30 |
| 1164973467 | Neuropsychology Associates, PC | Clinical Neuropsychologist | 1515 E Missouri Ave Ste 110, Phoenix, AZ 85014-2443 | 2016-10-21 |
| 1437524733 | Pinnacle Center, Inc. | Clinical Neuropsychologist | 4423 N 24th St, Phoenix, AZ 85016-5544 | 2015-12-11 |
| 1275969867 | Kiran Amin | Clinical Neuropsychologist | 720 E Peoria Ave, Phoenix, AZ 85020-1575 | 2013-09-16 |
| 1164864161 | Surabhi Yeshwant Patwardhan | Clinical Neuropsychologist | 3550 N Central Ave Ste 1407, Phoenix, AZ 85012-2112 | 2013-07-19 |
| 1366798050 | Irna Lynn Shamos | Clinical Neuropsychologist | 4516 East Onyx Avenue, Arizona Psychological Diagnostics, Plc, Phoenix, AZ 85028 | 2012-07-31 |
| 1295007557 | Robin C Ford | Clinical Neuropsychologist | 4144 N 44th St Ste E, Phoenix, AZ 85018-4260 | 2012-02-02 |
| 1699954800 | Barbara M Maxwell, Phd, Plc | Clinical Neuropsychologist | 11001 N 7th St, 1183, Phoenix, AZ 85020-1142 | 2007-10-24 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.