Provider Demographics
NPI:1871096008
Name:RUSH, CHRISTIE LYNN (LISW)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LYNN
Last Name:RUSH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:646 GARRY RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1758
Mailing Address - Country:US
Mailing Address - Phone:330-310-7343
Mailing Address - Fax:
Practice Address - Street 1:646 GARRY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-1758
Practice Address - Country:US
Practice Address - Phone:330-310-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.23048061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical