Theresa Lynn Rust, PCC-S, LSW, LICDC-CS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

240672 Issued in KY

Practice address

80 Highway 2227
Somerset, KY 42503-1562

Phone

(513) 475-2702

NPI assigned

Jun 25, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY, OH2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Protea Behavioral Health Counseling, PLLC

  • Professional Counselor
  • Somerset, KY
  • NPI 1205429800

  Addiction (Substance Use Disorder), OH

  Medicare reassignment NPD
• Protea Behavioral Health Counseling, PLLC

  • Mental Health Counselor
  • Dayton, OH
  • NPI 1659136570

  Addiction (Substance Use Disorder)

  NPD

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1093197089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 HIGHWAY 2227",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031562",
            "telephone_number": "513-475-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 HIGHWAY 2227",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425031562",
            "telephone_number": "513-475-2702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8963 Kingsridge Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454581623",
            "country_code": "US",
            "telephone_number": "937-475-2702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "233 Parkers Mill Way",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425034152",
            "country_code": "US",
            "telephone_number": "937-475-2702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUST",
        "first_name": "THERESA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PCC-S, LSW, LICDC-CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "981323",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E 0004070 SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "240672",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "240672",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S 0019424",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0279638",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100731970",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Taylor Ruby, DMD
• Amy Russell, LCSW
• Emilee Moore Russell, M.A., CF-SLP
• Rodney Gordon Russell Jr., PT, DPT, CERT. DN
• Shelby Brooke Russell, MS, OTR/L
• Madison Ruth, BCBA
• Corna Rutherford, LPCC-S
• Dale Edward Rutledge Sr., M.D.
• Harold H. Rutledge, MD
• James Raymond Rybarczyk, PT

• Mental Health Counselor in Somerset, KY
• Providers in Somerset, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.