person
Gary Lee Russell, LPCC-S,LICDC
Mental Health Counselor in Mansfield, Ohio
NPI 1003394180

Gary Lee Russell is a Mental Health Counselor based in Ontario, OH and is specialized in Mental Health. Gary Lee Russell practices in Mansfield, OH and has the professional credentials of LPCC-S,LICDC. The NPI Number for Gary Lee Russell is 1003394180 and holds a License No. LICDC.162577 (Ohio).

The current practice location address for Gary Lee Russell is 151 Marion Ave, Mansfield, OH and can be reached out via phone at 419-774-9969.

Location: 151 Marion Ave, Mansfield, OH, 44906-1325
person
Provider Profile Details
NPI Number
1003394180
Provider Name
Gary Lee Russell
Credential
LPCC-S,LICDC
Provider Entity Type
Individual
Gender
Male
Address
151 Marion Ave, Mansfield, OH, 44906-1325
Phone Number
419-774-9969
Fax Number
Provider Enumeration Date
08/01/2018
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
151 Marion Ave
City
State
Zip
44903-2223
Phone Number
419-774-9969
Fax Number
person
Provider Business Mailing Address Details
Address
151 Marion Ave
City
State
Zip
44903-2223
Phone Number
419-774-9969
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
E.2001844-SUPV (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LICDC.162577 (Ohio)
Definition
Definition to come...
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