Provider Demographics
NPI:1083004410
Name:RUSHFORD, CHRISTINE (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:RUSHFORD
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3997 COMMONS DR W
Mailing Address - Street 2:SUITE C
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-8443
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3997 COMMONS DR W
Practice Address - Street 2:SUITE C
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-8443
Practice Address - Country:US
Practice Address - Phone:850-420-2640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health