Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
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Kelly A Bushur, CPPHD

Individual provider Clinical Psychologist · NPI 1629248406

Kelly A Bushur, CPPHD is a Clinical Psychologist in Carbondale, Illinois. Qualified in 1996, 30 years ago. Practices with St Louis Behavioral Medicine Institute Inc, a 70-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
30
Licensed in
IL
In the registry since
2008
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Practice location Address checks out

400 S Lewis Ln
Carbondale, IL 62901-3547 Not confirmed with CMS for 11 years — call before visiting
Phone: (618) 519-9900
Fax: (618) 529-1384
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 071005772 (IL)

Record details

NPI number1629248406
Entity typeIndividual (Type 1)
GenderFemale
Credentials CPPHD
Sole proprietorNo
NPI enumeratedMarch 7, 2008
Last updated in NPPESOctober 23, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice St. Louis Behavioral Medicine Institute Inc — 70 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients11
Services billed 99 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Colleagues at St Louis Behavioral Medicine Institute Inc

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 70 clinicians in the practice; 12 are shown here.

Other providers in Carbondale