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NPI Code Detail

MEDICARE: MRS. LENORE ANN RUST LICSW

MEDICARE:  MRS. LENORE ANN RUST  LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker231767MA
21041C0700XClinical Social Worker115753MA

General Provider Information

NPI Number : 1992862833
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LENORE ANN RUST LICSW
Provider Business Mailing Address
First Line : 50 SUNSET LN
Second Line :
City : PAXTON
State : MA
Zip : 01612-1198
Country : US
Telephone Number : 508-849-3293
Fax Number :
Provider Business Practice Location Address
First Line : 50 SUNSET LN
Second Line :
City : PAXTON
State : MA
Zip : 01612
Country : US
Telephone Number : 508-849-3293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2007
Last Update Date : 07/17/2018

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Directions to “ MRS. LENORE ANN RUST LICSW” Practice Location

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