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NPI Code Detail

MEDICARE: KASSONDRA LOURDES RUSH MS, CRC, LPC

MEDICARE: KASSONDRA LOURDES RUSH MS, CRC, LPC
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
1101YM0800XMental Health CounselorPC020174PA

General Provider Information

NPI Number : 1750103503
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSONDRA LOURDES RUSH MS, CRC, LPC
Provider Business Mailing Address
First Line : 5831 FORWARD AVE # 1527
Second Line :
City : PITTSBURGH
State : PA
Zip : 15217-2301
Country : US
Telephone Number : 412-634-4548
Fax Number :
Provider Business Practice Location Address
First Line : 2910 MCKELVEY RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15221-4542
Country : US
Telephone Number : 412-336-8832
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2024
Last Update Date : 05/05/2026

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