Provider Demographics
NPI:1972656254
Name:RUSK, JAMES C (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:C
Last Name:RUSK
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 GATES CIR FL 8
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-1120
Mailing Address - Country:US
Mailing Address - Phone:716-887-5779
Mailing Address - Fax:716-887-5801
Practice Address - Street 1:3 GATES CIR FL 8
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1120
Practice Address - Country:US
Practice Address - Phone:716-887-5779
Practice Address - Fax:716-887-5801
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0776641041C0700X
CA267231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical