MEDICARE: MS. TIFFANY ANNA RUSH LISW

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	1041C0700X	Clinical Social Worker	S-8276	OH
2	1041C0700X	Clinical Social Worker	I-0008276	OH

General Provider Information

NPI Number	:	1952357824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY ANNA RUSH LISW

Provider Business Mailing Address
First Line	:	2139 AUBURN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2989
Country	:	US
Telephone Number	:	513-792-7441
Fax Number	:	513-791-4042

Provider Business Practice Location Address
First Line	:	11140 MONTGOMERY RD STE 1100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-2309
Country	:	US
Telephone Number	:	513-792-7441
Fax Number	:	513-791-4042

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	03/03/2026

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