Healthcare Provider Details

I. General information

NPI: 1184200297
Provider Name (Legal Business Name): RHONDA TERESE RUSHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2021
Last Update Date: 02/09/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 STUBBS AVE
MONROE LA
71201-5627
US

IV. Provider business mailing address

130 S RIDGE RD
RAYVILLE LA
71269-7671
US

V. Phone/Fax

Practice location:
  • Phone: 318-816-5116
  • Fax: 318-855-3229
Mailing address:
  • Phone: 318-235-1451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: RHONDA RUSHING
Title or Position: OWNER/PROVIDER
Credential: PMHNPBC
Phone: 318-235-1451