Provider Demographics
NPI:1811236946
Name:RUSHNOCK, MELANIE M (MS, LPC, NCC, ACS)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:M
Last Name:RUSHNOCK
Suffix:
Gender:F
Credentials:MS, LPC, NCC, ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SPARTA AVE STE C-2A
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1120
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:350 SPARTA AVE STE C-2A
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1120
Practice Address - Country:US
Practice Address - Phone:862-432-6711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-09
Last Update Date:2021-03-26
Deactivation Date:2014-01-15
Deactivation Code:
Reactivation Date:2016-12-06
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00571900101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor