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Individual

MRS. THERESA LYNN RUST

Active
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Individual

MRS. THERESA LYNN RUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PCC-S, LSW, LICDC-CS

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
981323
OH
101YM0800X
Mental Health Counselor
Primary
240672
KY
101YM0800X
Mental Health Counselor
E 0004070 SUPV
OH
101YP2500X
Professional Counselor
240672
KY
104100000X
Social Worker
S 0019424
OH

Other

Enumeration date
06/25/2015
Last updated
11/21/2024
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