Provider Demographics
NPI:1477709111
Name:RUSHLOW, CAROLANN (PROVISIONAL LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLANN
Middle Name:
Last Name:RUSHLOW
Suffix:
Gender:F
Credentials:PROVISIONAL LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3210 FAIRHILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-3220
Mailing Address - Country:US
Mailing Address - Phone:919-256-0824
Mailing Address - Fax:919-256-0833
Practice Address - Street 1:105 W CORBIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2190
Practice Address - Country:US
Practice Address - Phone:919-245-1056
Practice Address - Fax:919-245-1057
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP003473390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program