Healthcare Provider Details

I. General information

NPI: 1770708968
Provider Name (Legal Business Name): LIFESPAN THERAPY SERVICES PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 W HIGH ST
MOUNT STERLING KY
40353-1328
US

IV. Provider business mailing address

318 W HIGH ST
MOUNT STERLING KY
40353-1328
US

V. Phone/Fax

Practice location:
  • Phone: 859-498-8647
  • Fax: 859-498-8677
Mailing address:
  • Phone: 859-498-8647
  • Fax: 859-498-8677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License NumberPT001459
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberR0059
License Number StateKY

VIII. Authorized Official

Name: CAROL A RUSHING-CARR
Title or Position: PRESIDENT
Credential: OTRL
Phone: 859-498-8647