Provider Demographics
NPI:1326656653
Name:RUSHING, ELISABETH FAETH (BCBA)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:FAETH
Last Name:RUSHING
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 BRITTANY HEYWORTH WAY APT 107
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3179
Mailing Address - Country:US
Mailing Address - Phone:502-758-4250
Mailing Address - Fax:
Practice Address - Street 1:5063 SW 56TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-7621
Practice Address - Country:US
Practice Address - Phone:787-425-1852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-22
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist