Provider Demographics
NPI:1659723260
Name:RUSH, BILLY JOHN JR (MS, BCBA, LBA)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:JOHN
Last Name:RUSH
Suffix:JR
Gender:M
Credentials:MS, BCBA, LBA
Other - Prefix:MR
Other - First Name:BILLY
Other - Middle Name:J
Other - Last Name:RUSH
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:MS, BCBA, LBA
Mailing Address - Street 1:120 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:CARRIERE
Mailing Address - State:MS
Mailing Address - Zip Code:39426-8304
Mailing Address - Country:US
Mailing Address - Phone:601-799-7874
Mailing Address - Fax:
Practice Address - Street 1:120 SMITH ST APT A
Practice Address - Street 2:
Practice Address - City:CARRIERE
Practice Address - State:MS
Practice Address - Zip Code:39426-8304
Practice Address - Country:US
Practice Address - Phone:601-799-7874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst