Healthcare Provider Details

I. General information

NPI: 1497665566
Provider Name (Legal Business Name): ALYSHA RUSHING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 HULBERT AVE
PONCHA SPRINGS CO
81242
US

IV. Provider business mailing address

224 W RAINBOW BLVD PMB 234
SALIDA CO
81201
US

V. Phone/Fax

Practice location:
  • Phone: 903-241-2111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0020702
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: