MEDICARE: TIMOTHY ERIN RUSH LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	03768	KS

General Provider Information

NPI Number	:	1538830781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY ERIN RUSH LCPC

Provider Business Mailing Address
First Line	:	PO BOX 67214
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66667-0214
Country	:	US
Telephone Number	:	785-224-1861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 SW WANAMAKER RD STE 2
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66604-3805
Country	:	US
Telephone Number	:	785-224-1861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2021
Last Update Date	:	08/03/2024

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