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LARISSA CLAIR BUSH
NPI 1528907151
Speech-Language Pathologist in Woodbury, MN

Active since March 27, 2026
2080 WOODDALE DR, WOODBURY, MN 55125(612) 201-2468 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Larissa Clair Bush NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LARISSA CLAIR BUSH (NPI 1528907151) is an individual speech-language pathologist provider in Woodbury, Minnesota and active in the NPI registry since March 2026. She maintains a secondary practice location in New Hope and is a graduate of Other (2025).

NPPES Registry Identity

NPI1528907151
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameLARISSA CLAIR BUSH
Location Address2080 WOODDALE DRWoodbury, MN 55125-2924
Mailing Address55 Livingston Ave Apt 320Saint Paul, MN 55107-5700
Phone(612) 201-2468
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateMarch 27, 2026
NPPES CertifiedMarch 27, 2026
✔ NPI 1528907151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
2080 WOODDALE DR, Woodbury, MN 55125
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Secondary Practice Location 1

Location 14900 Highway 169 N Ste 100New Hope, MN 55428-4044 · Phone (612) 877-8800

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Larissa Clair Bush is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1951879659
PECOS Enrollment IDI20260511001916

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HUNTER WAYNE
Behavior Technician
2080 WOODDALE DR
WOODBURY, MN 55125
Washington County (651) 431-6628
BEA WILLOW HANSEN
Behavior Technician
2080 WOODDALE DR
WOODBURY, MN 55125
Washington County (651) 431-6628
TESSAH GREEN
Behavior Technician
2080 WOODDALE DR
WOODBURY, MN 55125
Washington County (612) 201-2468
BRENT JOSEPH RELLER
Behavior Technician
2080 WOODDALE DR
WOODBURY, MN 55125
Washington County (651) 431-6628

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Larissa Bush's NPI number?

The NPI number for Larissa Bush is 1528907151. It was assigned to this individual provider in the NPPES registry on March 27, 2026.

Where is Larissa Bush located?

Larissa Bush practices at 2080 Wooddale Dr, Woodbury, MN 55125. The listed phone number is (612) 201-2468.

What is Larissa Bush's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Larissa Bush enrolled in Medicare?

Yes. Larissa Bush is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Larissa Bush was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.