{"npi":"1356419790","type":"NPI-1","status":"active","name":{"display":"Laronta Rush PH.D.","other":[{"code":"1","type":"Formerly known as","value":"UPSON, LARONTA M"}],"first":"LARONTA","last":"RUSH","middle":"UPSON","credential":"PH.D."},"specialty":{"primary_taxonomy":"103TC2200X","primary_taxonomy_description":"Clinical Child & Adolescent Psychologist","slug":"clinical-child-adolescent-psychologist","schema_org_specialty":null,"all":[{"code":"103T00000X","description":"Psychologist","primary":false,"state":"GA","license":"003025"},{"code":"103TS0200X","description":"School Psychologist","primary":false,"state":"GA","license":"003025"},{"code":"103TC2200X","description":"Clinical Child & Adolescent Psychologist","primary":true,"state":"GA","license":"003025"}]},"addresses":[{"purpose":"LOCATION","street_1":"3760 LAVISTA RD STE 102","city":"TUCKER","state":"GA","postal_code":"300845622","country_code":"US","phone":"7703758124","fax":"7705595543"},{"purpose":"MAILING","street_1":"3760 LAVISTA RD STE 102","city":"TUCKER","state":"GA","postal_code":"300845622","country_code":"US","phone":"7703758124","fax":"7705595543"}],"license":{"state":"GA","number":"003025"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"636448495E","state":"GA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-12-02","last_updated":"2024-08-14","_meta":{"source":"NPPES","snapshot_date":"2024-08-14","doc_url":"https://findmynpi.com/api"}}