Provider Demographics
NPI:1710141510
Name:RUSHING, CHERYL ELIZABETH (LPC-S, PHD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ELIZABETH
Last Name:RUSHING
Suffix:
Gender:F
Credentials:LPC-S, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BRIARCROFT LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5600
Mailing Address - Country:US
Mailing Address - Phone:817-557-7574
Mailing Address - Fax:
Practice Address - Street 1:150 BRIARCROFT LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-5600
Practice Address - Country:US
Practice Address - Phone:817-557-7574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-11
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62340101Y00000X, 101YM0800X, 101YP2500X
GALPC010082101YP2500X
TX101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196873701Medicaid