Provider Demographics
NPI:1891841003
Name:RUSH CREEK COUNSELING CENTER
Entity Type:Organization
Organization Name:RUSH CREEK COUNSELING CENTER
Other - Org Name:THE CHURCH ON RUSH CREEK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF COUNSELING
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:817-468-7729
Mailing Address - Street 1:2300 SW GREEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-3708
Mailing Address - Country:US
Mailing Address - Phone:187-468-7729
Mailing Address - Fax:817-701-0379
Practice Address - Street 1:2300 SW GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-3708
Practice Address - Country:US
Practice Address - Phone:187-468-7729
Practice Address - Fax:817-701-0379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty