Bon J Rush, LSAA
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mescalero, NM
NPI 1104670694 · NPPES record last updated Apr 12, 2024
Key facts
- NPI
- 1104670694
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CTB-2023-0647 (NM)
- Practice address
- 107 Sunset Loop
Mescalero, NM 88340 - Phone
- (575) 464-2827
- Fax
- (575) 464-4321
- NPI assigned
- Apr 12, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CTB-2023-0647 | NM | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CTB-2023-0647 | NM | Yes |
Addresses
Primary practice location
107 Sunset Loop
Mescalero, NM 88340
Mailing address
212 Sunny Slope Dr
Ruidoso, NM 88345-7258
Phone (940) 231-4929
Other providers in Mescalero, NM
- Kathryn Patterson
- James Peralto
- Thomas S. Raffaele
- Marina Rice
- Julian Romero
- Ida L Saenz
- Reyes A Sanchez
- Judy Gutierrez Sarabia
- Walter Scott
- Loretta R Shanta
All providers in Mescalero, NM · Addiction (Substance Use Disorder) Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.