Kevin Douglas Rushing, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.090590 Issued in OH

Practice address

4808 Amesbury Rd
Toledo, OH 43612-2008

Phone

(419) 461-2165

NPI assigned

Jul 9, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Growth Counseling Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Toledo, OH
  • NPI 1023776028
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1053807461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4808 AMESBURY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436122008",
            "telephone_number": "419-461-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4808 AMESBURY RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436122008",
            "telephone_number": "419-461-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHING",
        "first_name": "KEVIN",
        "middle_name": "DOUGLAS",
        "credential": "CDCA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-09",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.090590",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Rupp
• Victoria Rurak
• Jacob L Rusch
• Jason M Rush
• Kellilyn Rush
• Liandrin Rushing
• Jacob Joseph Rusk, MD
• De Ante Russ
• John Albert Russ III, MD
• Antuanette Russell

• Addiction (Substance Use Disorder) Counselor in Toledo, OH
• Providers in Toledo, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.