Provider Demographics
NPI:1043357817
Name:RUSHBROOK, MINDY (MSS, LCSW)
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:RUSHBROOK
Suffix:
Gender:F
Credentials:MSS, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:PA
Mailing Address - Zip Code:19007-4212
Mailing Address - Country:US
Mailing Address - Phone:215-964-3395
Mailing Address - Fax:
Practice Address - Street 1:670 WOODBOURNE RD
Practice Address - Street 2:4 CORNERSTONE DR
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1847
Practice Address - Country:US
Practice Address - Phone:215-757-6916
Practice Address - Fax:215-757-2115
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0160491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical