Provider Demographics
NPI:1972034932
Name:RUSTON, LINDSAY (LPCC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:RUSTON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:LIDNSAY
Other - Middle Name:
Other - Last Name:BASTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2730 MILL CREEK RD
Mailing Address - Street 2:
Mailing Address - City:MENTONE
Mailing Address - State:CA
Mailing Address - Zip Code:92359-9807
Mailing Address - Country:US
Mailing Address - Phone:909-660-0041
Mailing Address - Fax:
Practice Address - Street 1:2730 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:MENTONE
Practice Address - State:CA
Practice Address - Zip Code:92359-9807
Practice Address - Country:US
Practice Address - Phone:909-660-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC7089101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional