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Kelly A Bushur, CPPHD
Clinical Psychologist in Carbondale, Illinois
NPI 1629248406

Kelly A Bushur is a Clinical Psychologist based in Carterville, IL and is specialized in Clinical. Kelly A Bushur practices in Carbondale, IL and has the professional credentials of CPPHD. The NPI Number for Kelly A Bushur is 1629248406 and holds a License No. 071005772 (Illinois).

The current practice location address for Kelly A Bushur is 400 S Lewis Ln, Carbondale, IL and can be reached out via phone at 618-519-9900 and via fax at 618-529-1384.

Location: 400 S Lewis Ln, Carbondale, IL, 62918-0577
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1629248406
Provider Name
Kelly A Bushur
Credential
CPPHD
Provider Entity Type
Individual
Gender
Female
Address
400 S Lewis Ln, Carbondale, IL, 62918-0577
Phone Number
618-519-9900
Fax Number
618-529-1384
Provider Enumeration Date
03/07/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
370966854006 05 IL
370966854015 05 IL
370966854002 05 IL
370966854024 05 IL
370966854005 05 IL
640701 01 IL MEDICARE GROUP ID
institution
Provider Business Practice Location Address Details
Address
400 S Lewis Ln
City
Carbondale
State
Illinois
Zip
62901-3547
Phone Number
618-519-9900
Fax Number
618-529-1384
person
Provider Business Mailing Address Details
Address
400 S Lewis Ln
City
Carbondale
State
Illinois
Zip
62901-3547
Phone Number
618-519-9900
Fax Number
618-529-1384
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Clinical
Taxonomy
103TC0700X
License No.
071005772 (Illinois)
Definition
A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.
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