Amy Ruth Rakusin, LCPC, ADTR, NCC
Individual provider Active NPI Professional Counselor · Phoenix, MD
NPI 1093977134 · NPPES record last updated Sep 11, 2023
Key facts
- NPI
- 1093977134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LCO653 (MD)
- Practice address
- 10 Cross Creek CT
Phoenix, MD 21131-1000 - Phone
- (410) 472-3060
- Fax
- (410) 472-9958
- NPI assigned
- Jun 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
10 Cross Creek CT
Phoenix, MD 21131-1000
Phone (410) 472-3060
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231213000324 | MD | Practitioner - Mental Health Counselor | 4880041086 |
Reassigns benefits to 1 organization Practice locations: Phoenix, MD |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCO653 | MD | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhythms, Inc | Professional | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCO653 | MD | Yes |
Addresses
Primary practice location
10 Cross Creek CT
Phoenix, MD 21131-1000
Mailing address
10 Cross Creek CT
Phoenix, MD 21131-1000
Phone (410) 472-3060
Other providers in Phoenix, MD
- Kristin Marie Pelletier
- David Alan Perrott
- Phoenix Family Counseling LLC
- Prana Healthcare Staffing
- John Jerome Pycha
- Rhythms, Inc
- Hong Rosado
- Ashley H Ruocco
- Kenneth Barry Sharoff
- Nancy Lee Sharoff
All providers in Phoenix, MD · Professional Counselor in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.