Healthcare Provider Details

I. General information

NPI: 1245762558
Provider Name (Legal Business Name): CAROL RUSH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 S MAIN ST
CAPE MAY COURT HOUSE NJ
08210-2240
US

IV. Provider business mailing address

PO BOX 6573
LAWRENCEVILLE NJ
08648-0573
US

V. Phone/Fax

Practice location:
  • Phone: 609-844-0452
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: