Provider Demographics
NPI:1104163195
Name:KUSH, NATASHA XENIA
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:XENIA
Last Name:KUSH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 OAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1149
Mailing Address - Country:US
Mailing Address - Phone:828-298-0186
Mailing Address - Fax:828-298-4870
Practice Address - Street 1:50 REDDICK RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2717
Practice Address - Country:US
Practice Address - Phone:828-298-0186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7794101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health