Provider Demographics
NPI:1154148005
Name:ROSENBUSH, ERIN (PSYS)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ROSENBUSH
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7756 W DELPHI PIKE # 27
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:IN
Mailing Address - Zip Code:46919-9518
Mailing Address - Country:US
Mailing Address - Phone:765-536-0032
Mailing Address - Fax:
Practice Address - Street 1:7756 W DELPHI PIKE # 27
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:IN
Practice Address - Zip Code:46919-9518
Practice Address - Country:US
Practice Address - Phone:765-536-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10159364103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool