Provider Demographics
NPI:1285916387
Name:RUSH, KATHLEEN E (ASW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:RUSH
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:E
Other - Last Name:KVARME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1861 SILVERWOOD DR # 1
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-1352
Mailing Address - Country:US
Mailing Address - Phone:925-687-0202
Mailing Address - Fax:
Practice Address - Street 1:1861 SILVERWOOD DR # 1
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-1352
Practice Address - Country:US
Practice Address - Phone:925-687-0202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program