Individual provider Active NPI

Nancy Ann Rush II, MA,LCSW,LPC,ALPS

  • Mental Health Counselor
  • Bridgeport, WV
National Provider Identifier
1760568026
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
CP00453683/513 Issued in WV
Practice address
243 W Main St
Progressive Preventive Health Care
Bridgeport, WV 26330-1748
Phone
(304) 842-8852
Fax
(304) 842-8853
NPI assigned
Oct 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CP00453683/513 WV Primary

Addresses

Primary practice location

243 W Main St
Progressive Preventive Health Care
Bridgeport, WV 26330-1748

Mailing address

243 W Main St
Bridgeport, WV 26330-1748
Phone (304) 842-8852

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241022003859 WV Practitioner - Mental Health Counselor 4981634722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
West Virginia University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

243 W Main St
Bridgeport, WV 26330-1767
Phone (304) 842-8852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CP00453683/513WVMDMental Health Counselor
513WVMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Preventive Health Care, Inc Mental Health CurrentSince Sep 16, 2024 Accepting new patients

Locations

243 W Main St
Bridgeport, WV 26330
Phone (304) 842-8852

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760568026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 W MAIN ST",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301748",
            "telephone_number": "304-842-8852",
            "fax_number": "304-842-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 W MAIN ST",
            "address_2": "PROGRESSIVE PREVENTIVE HEALTH CARE",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301748",
            "telephone_number": "304-842-8852",
            "fax_number": "304-842-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "NANCY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "name_suffix": "II",
        "credential": "MA,LCSW,LPC,ALPS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "CP00453683/513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.