Rush, Laronta Upson

Rush, Laronta Upson is an sole proprietor health care provider with primary practice located at 3760 Lavista Rd Ste 102 , Tucker GA 30084-5622. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical Child & Adolescent is her primary health care specialty. Rush, Laronta Upson can be contacted via phone (770) 375-8124.

Contact Information

Primary practice address
3760 Lavista Rd Ste 102 Tucker GA 30084-5622
Phone: (770) 375-8124
Fax: (770) 559-5543
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 003025 Georgia
Behavioral Health & Social Service Providers / School 103TS0200X 003025 Georgia
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 003025 Georgia

Profile Details

NPI number 1356419790
LBN Legal business name Rush, Laronta Upson
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 2nd, 2006
Last updated Nov 30th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356419790 NPPES
Georgia MEDICAID 636448495E

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