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General NPI Number Information
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NPI Number | 1447768692
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Entity Type | Organization
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Legal Business Name | RDR COUNSELING SERVICES
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Dates
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Enumeration Date | 01/22/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 1428 WEATHERLY RD SE STE 104
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City | HUNTSVILLE
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State | AL
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Zip | 35803-1181
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Country | US
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Telephone | 256-288-3827
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Fax | 256-288-3828
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Provider Business Mailing Address
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Address Line | 1428 WEATHERLY RD SE STE 104
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City | HUNTSVILLE
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State | AL
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Zip | 35803-1181
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Country | US
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Telephone | 256-288-3827
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Fax | 256-288-3828
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Authorized Official
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Title or Position | OWNER
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Name | RANDY DERRELL RUSH
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Credential | DMIN, LPC
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Telephone | 256-288-3827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3030
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License Number State | AL
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