Provider Demographics
NPI:1154606333
Name:BOATWRIGHT, EMILY RUSH (LPC-MHSP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RUSH
Last Name:BOATWRIGHT
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 N MAPLE ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ADAMSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38310-1823
Mailing Address - Country:US
Mailing Address - Phone:731-234-4598
Mailing Address - Fax:731-632-4357
Practice Address - Street 1:224 N MAPLE ST
Practice Address - Street 2:SUITE C
Practice Address - City:ADAMSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38310-1823
Practice Address - Country:US
Practice Address - Phone:731-234-4598
Practice Address - Fax:731-632-4357
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2744101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health