Provider Demographics
NPI:1447400221
Name:ROUSH, CRAIG E (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:E
Last Name:ROUSH
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 21
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47448-0021
Mailing Address - Country:US
Mailing Address - Phone:812-219-4228
Mailing Address - Fax:812-523-8416
Practice Address - Street 1:1725 E TIPTON ST
Practice Address - Street 2:STE. 200
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-3561
Practice Address - Country:US
Practice Address - Phone:812-219-4228
Practice Address - Fax:812-523-8416
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health