Provider Demographics
NPI:1477826402
Name:RUSHING, CRAIG A
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:A
Last Name:RUSHING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 PLYMOUTH CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1661
Mailing Address - Country:US
Mailing Address - Phone:410-562-5248
Mailing Address - Fax:410-800-4781
Practice Address - Street 1:4710 PENNINGTON AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21226-1405
Practice Address - Country:US
Practice Address - Phone:410-562-5248
Practice Address - Fax:410-800-4781
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1730101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional