Provider Demographics
NPI:1134247232
Name:RUSE, FRANK DAVID (LISW (CP) LADC)
Entity type:Individual
Prefix:MR
First Name:FRANK
Middle Name:DAVID
Last Name:RUSE
Suffix:
Gender:M
Credentials:LISW (CP) LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 RIVERS AVE
Mailing Address - Street 2:NAVAL HOSPITAL CHARLESTON
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-7747
Mailing Address - Country:US
Mailing Address - Phone:843-743-0306
Mailing Address - Fax:843-743-0334
Practice Address - Street 1:3600 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-7747
Practice Address - Country:US
Practice Address - Phone:843-743-7868
Practice Address - Fax:843-743-7521
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC88331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical