Provider Demographics
NPI:1346601598
Name:WINCHESTER, RUSH BERRYHILL JR (PHD, MS)
Entity Type:Individual
Prefix:DR
First Name:RUSH
Middle Name:BERRYHILL
Last Name:WINCHESTER
Suffix:JR
Gender:M
Credentials:PHD, MS
Other - Prefix:
Other - First Name:RUSTY
Other - Middle Name:
Other - Last Name:WINCHESTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, MS
Mailing Address - Street 1:201 W SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5158
Mailing Address - Country:US
Mailing Address - Phone:865-637-9711
Mailing Address - Fax:
Practice Address - Street 1:2455 SUTHERLAND AVE BLDG B
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919
Practice Address - Country:US
Practice Address - Phone:865-558-9040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator