Provider Demographics
NPI:1194126854
Name:SPEAR, RUSHIE COURTNEY NEWMAN
Entity type:Individual
Prefix:MS
First Name:RUSHIE
Middle Name:COURTNEY NEWMAN
Last Name:SPEAR
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 1:129 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-1001
Mailing Address - Country:US
Mailing Address - Phone:606-796-6400
Mailing Address - Fax:
Practice Address - Street 1:129 SECOND ST
Practice Address - Street 2:
Practice Address - City:VANCEBURG
Practice Address - State:KY
Practice Address - Zip Code:41179-1001
Practice Address - Country:US
Practice Address - Phone:606-796-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY181103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical