Provider Demographics
NPI:1962707661
Name:RUSHING, TINA K (LCSW)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:K
Last Name:RUSHING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 TUPELO DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5130
Mailing Address - Country:US
Mailing Address - Phone:903-738-1132
Mailing Address - Fax:
Practice Address - Street 1:109 TUPELO DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5130
Practice Address - Country:US
Practice Address - Phone:903-738-1132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX190221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical