Kelly A. Bushur, CP PH.D
NPI 1629248406ActiveIndividual· Psychologist, Clinical· Carbondale, IL
Psychologist, Clinical (CP PH.D) with St. Louis Behavioral Medicine Institute Inc, practicing in Carbondale, Illinois. Medicare paid $9,896 for services to 11 patients in 2024.
Overview
| NPI | 1629248406 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CP PH.D |
| Sole proprietor | No |
| NPI issued | Mar 7, 2008 |
| Last updated in NPPES | Oct 23, 2014 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist, Clinical Primary | 103TC0700X | 071005772 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (MO) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 11 |
|---|---|
| Services billed | 99 across 3 procedure codes |
| Paid by Medicare | $9,896 |
Education and affiliations
| Graduation year | 1996 |
|---|---|
| Medicare specialty | Clinical Psychologist |
Medical group
- St. Louis Behavioral Medicine Institute IncSaint Louis, MO · 67 clinicians
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All 28 clinical psychologists in Carbondale · All clinical psychologists in Illinois