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Russ Blackstone
Mental Health Counselor in Buffalo, New York
NPI 1245004910

Russ Blackstone is a Mental Health Counselor based in Buffalo, NY and is specialized in Mental Health. Russ Blackstone practices in Buffalo, NY. The NPI Number for Russ Blackstone is 1245004910 and holds a License No. P112395 (New York).

The current practice location address for Russ Blackstone is 1515 Kensington Ave Ste 103, Buffalo, NY and can be reached out via phone at 716-697-7380.

Location: 1515 Kensington Ave Ste 103, Buffalo, NY, 14215-1436
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1245004910
Provider Name
Russ Blackstone
Credential
Provider Entity Type
Individual
Gender
Male
Address
1515 Kensington Ave Ste 103, Buffalo, NY, 14215-1436
Phone Number
716-697-7380
Fax Number
Provider Enumeration Date
11/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1515 Kensington Ave Ste 103
City
Buffalo
State
New York
Zip
14215-1436
Phone Number
716-697-7380
Fax Number
person
Provider Business Mailing Address Details
Address
1515 Kensington Ave Ste 103
City
Buffalo
State
New York
Zip
14215-1436
Phone Number
716-697-7380
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
P112395 (New York)
Definition
Definition to come...
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