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General NPI Number Information
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NPI Number | 1376348706
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Entity Type | Individual
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Provider Name | THOMAS O'NEAL CUSHMAN PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 1209 N FANT ST
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City | ANDERSON
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State | SC
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Zip | 29621-4821
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Country | US
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Telephone | 864-353-3384
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Fax | 864-222-9715
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Provider Business Mailing Address
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Address Line | 1209 N FANT ST
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City | ANDERSON
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State | SC
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Zip | 29621-4821
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Country | US
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Telephone | 864-353-3384
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Fax | 864-222-9715
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 29990
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License Number State | SC
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