Provider Demographics
NPI:1841466166
Name:RAUSCHENBERG, EUNISA LEIGH (MS, ATR-BC, LCAT)
Entity type:Individual
Prefix:MS
First Name:EUNISA
Middle Name:LEIGH
Last Name:RAUSCHENBERG
Suffix:
Gender:F
Credentials:MS, ATR-BC, LCAT
Other - Prefix:MS
Other - First Name:NISA
Other - Middle Name:LEIGH
Other - Last Name:RAUSCHENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, ATR-BC, LCAT
Mailing Address - Street 1:28 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-2806
Mailing Address - Country:US
Mailing Address - Phone:845-358-1163
Mailing Address - Fax:
Practice Address - Street 1:28 W BROADWAY
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-2806
Practice Address - Country:US
Practice Address - Phone:845-358-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000393-1101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000393-1OtherNEW YORK STATE DEPARTMENT OF EDUCATION/OFFICE OF THE PROFESSIONS
NY05-220OtherART THERAPY CREDENTIALS BOARD