Active NPI
Wayne Rushlow
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1184915175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1215
- Practice address
- 107 Lincoln St
Worcester, MA 01605-2401 - Phone
- (508) 453-3013
- Fax
- (508) 795-0224
- NPI assigned
- Apr 25, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1215 | MA | Primary |
Addresses
Primary practice location
107 Lincoln St
Worcester, MA 01605-2401
Mailing address
107 Lincoln St
Worcester, MA 01605-2401
Phone (508) 453-3013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1215 | MA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303689600000",
"number": "1184915175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 LINCOLN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052401",
"telephone_number": "508-453-3013",
"fax_number": "508-795-0224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 LINCOLN ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052401",
"telephone_number": "508-453-3013",
"fax_number": "508-795-0224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSHLOW",
"first_name": "WAYNE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-25",
"last_updated": "2011-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "1215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.