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Jeremy K Russell, MA,QMHP
Mental Health Counselor in Cottage Grove, Oregon
NPI 1396923074

Jeremy K Russell is a Mental Health Counselor based in Cottage Grove, OR and is specialized in Mental Health. Jeremy K Russell practices in Cottage Grove, OR and has the professional credentials of MA,QMHP. The NPI Number for Jeremy K Russell is 1396923074 and holds a License No. (Oregon).

The current practice location address for Jeremy K Russell is 410 N 9Th St, Cottage Grove, OR and can be reached out via phone at 541-942-2850 and via fax at 541-942-1574.

Location: 410 N 9Th St, Cottage Grove, OR, 97424-1307
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396923074
Provider Name
Jeremy K Russell
Credential
MA,QMHP
Provider Entity Type
Individual
Gender
Male
Address
410 N 9Th St, Cottage Grove, OR, 97424-1307
Phone Number
541-942-2850
Fax Number
541-942-1574
Provider Enumeration Date
02/05/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
019047 05 OR
institution
Provider Business Practice Location Address Details
Address
410 N 9Th St
City
Cottage Grove
State
Oregon
Zip
97424-1307
Phone Number
541-942-2850
Fax Number
541-942-1574
person
Provider Business Mailing Address Details
Address
410 N 9Th St
City
Cottage Grove
State
Oregon
Zip
97424-1307
Phone Number
541-942-2850
Fax Number
541-942-1574
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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