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1548391873 NPI number — VICTORIA CHARLENE RUSH LPC

NPI Number: 1548391873
Health Care Provider/Practitioner: VICTORIA CHARLENE RUSH LPC

Information about “1548391873” NPI (VICTORIA CHARLENE RUSH LPC) exists in 1548391873 in HTML format HTML  |  1548391873 in plain Text format TXT  |  1548391873 in PDF (Portable Document Format) PDF  |  1548391873 in an XML format XML  formats.

NPI Number : 1548391873 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1548391873",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "RUSH",
    "FirstName": "VICTORIA",
    "MiddleName": "CHARLENE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "LPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3771 RAMSEY ST",
    "SecondLineMailingAddress": "SUITE 109-119",
    "MailingAddressCityName": "FAYETTEVILLE",
    "MailingAddressStateName": "NC",
    "MailingAddressPostalCode": "28311-7675",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "910-630-6463",
    "MailingAddressFaxNumber": "910-630-6461",
    "FirstLinePracticeLocationAddress": "5511 RAMSEY ST",
    "SecondLinePracticeLocationAddress": "SUITE 201-A",
    "PracticeLocationAddressCityName": "FAYETTEVILLE",
    "PracticeLocationAddressStateName": "NC",
    "PracticeLocationAddressPostalCode": "28311-1497",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "910-630-6463",
    "PracticeLocationAddressFaxNumber": "910-630-6461",
    "EnumerationDate": "03/08/2007",
    "LastUpdateDate": "02/27/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YP2500X",
        "TaxonomyName": "Professional Counselor",
        "LicenseNumber": "6495",
        "LicenseNumberStateCode": "NC",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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