Kelly A Bushur
CP PH.D | Clinical Psychologist | 29+ years Exp
400 S Lewis Ln, Carbondale
Illinois, 62901-3547
618-519-9900 618-529-1384
Maps & DirectionsKelly A Bushur is a Carbondale, Illinois based psychologist with 29 years of experience in Clinical Psychology. She completed her graduation in 1996. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Kelly A Bushur is 071005772 for Clinical Psychology in Illinois. Her current practice location is 400 S Lewis Ln, Carbondale. Patients can reach her at 618-519-9900 or can fax her at 618-529-1384. Kelly A Bushur is CP PH.D in Clinical Psychology and her NPI number (Unique professional ID assigned by NPPES) is 1629248406.
Kelly A Bushur is a mental health professional with highly specialized training in the diagnosis and psychological treatment of mental, behavioral and emotional illnesses, including obsessive-compulsive disorder (OCD). Her main focus is on diagnosing and treating mental, emotional, and behavioral disorders. Some of the common disorders that she can treat are learning disabilities, substance abuse, depression, anxiety, and eating disorders.
Complete Profile:
Kelly A Bushur speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Kelly A Bushur |
| Specialization: | Clinical Psychology |
| Gender: | Female |
| Credentials: | CP PH.D |
| Experience: | 29+ years |
| Medical School Attended: | Other |
| Graduation Year: | 1996 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 400 S Lewis Ln, Carbondale,
Illinois, 62901-3547 |
| Phone: | 618-519-9900 |
| Fax: | 618-529-1384 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 3577746197 |
| Enrollment ID: | I20141001000447 |
| NPI Number: | 1629248406 |
| NPI Enumeration Date: | 07 Mar, 2008 |
| NPI Last Update On: | 23 Oct, 2014 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Kelly A Bushur are as mentioned below.
| License Number | Specialization | State | Status | |
| 071005772 | Clinical Psychology | Illinois | Primary | |
Group Practice:
Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name
with which Kelly A Bushur is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| St. Louis Behavioral Medicine Institute Inc (3173428638) | 43 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Kelly A Bushur such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 370966854006 | Medicaid | Illinois | |
| 370966854015 | Medicaid | Illinois | |
| 370966854002 | Medicaid | Illinois | |
| 370966854024 | Medicaid | Illinois | |
| 370966854005 | Medicaid | Illinois | |
| 640701 | Other | Illinois | MEDICARE GROUP ID |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Kelly A Bushur
Po Box 577,
Carterville, Illinois |
| Zip: | 62918-0577 |
| Phone Number: | 618-985-8221 |
| Fax Number: | 618-985-6860 |
Patients can reach Kelly A Bushur at
400 S Lewis Ln, Carbondale, Illinois or can
call to book an appointment on 618-519-9900.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.