Healthcare Provider Details

I. General information

NPI: 1750653838
Provider Name (Legal Business Name): LYNETTE ADRIANNE RUSHING PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2012
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2197
US

IV. Provider business mailing address

620 JOHN PAUL JONES CIR
PORTSMOUTH VA
23708-2197
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-9967
  • Fax:
Mailing address:
  • Phone: 757-953-9967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810004431
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: