Provider Demographics
NPI:1568562270
Name:RUSCHHAUPT, VIRGINIA (LPC)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:RUSCHHAUPT
Suffix:
Gender:F
Credentials:LPC
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 718
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-0718
Mailing Address - Country:US
Mailing Address - Phone:361-578-7441
Mailing Address - Fax:
Practice Address - Street 1:2006 N NAVARRO ST STE C
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-4823
Practice Address - Country:US
Practice Address - Phone:361-578-7441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-23
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10997101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0262883-01Medicaid