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NPI Code Detail

MEDICARE: MRS. TECKY ANN RUSK LPCC-S

MEDICARE: MRS. TECKY ANN RUSK LPCC-S
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
1101YP2500XProfessional CounselorE.1800504OH
2101YP2500XProfessional CounselorE.1800504-SUPVOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1952768269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TECKY ANN RUSK LPCC-S
Provider Business Mailing Address
First Line : 125 S MAIN ST STE 305
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-2361
Country : US
Telephone Number : 567-429-1000
Fax Number : 419-436-7460
Provider Business Practice Location Address
First Line : 125 S MAIN ST STE 305
Second Line :
City : FOSTORIA
State : OH
Zip : 44830-2361
Country : US
Telephone Number : 567-429-1000
Fax Number : 419-436-7460
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2016
Last Update Date : 09/11/2024

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