Provider Demographics
NPI:1063181527
Name:BUSH, NATASHA RENEE (LMFT)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:RENEE
Last Name:BUSH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1998
Mailing Address - Country:US
Mailing Address - Phone:203-275-9763
Mailing Address - Fax:
Practice Address - Street 1:370 LINWOOD ST # 1949
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1998
Practice Address - Country:US
Practice Address - Phone:203-275-9763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-08
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist