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Russell Prause, MS,LAC
Mental Health Counselor in Glendale, Arizona
NPI 1417560806

Russell Prause is a Mental Health Counselor based in Glendale, AZ and is specialized in Mental Health. Russell Prause practices in Glendale, AZ and has the professional credentials of MS,LAC. The NPI Number for Russell Prause is 1417560806 and holds a License No. LAC-18437 (Arizona).

The current practice location address for Russell Prause is 17431 N 71St Dr Ste 103, Glendale, AZ and can be reached out via phone at 602-633-2246.

Location: 17431 N 71St Dr Ste 103, Glendale, AZ, 85308-8598
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417560806
Provider Name
Russell Prause
Credential
MS,LAC
Provider Entity Type
Individual
Gender
Male
Address
17431 N 71St Dr Ste 103, Glendale, AZ, 85308-8598
Phone Number
602-633-2246
Fax Number
Provider Enumeration Date
08/26/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
17431 N 71St Dr Ste 103
City
Glendale
State
Arizona
Zip
85308-8598
Phone Number
602-633-2246
Fax Number
person
Provider Business Mailing Address Details
Address
17431 N 71St Dr Ste 103
City
Glendale
State
Arizona
Zip
85308-8598
Phone Number
602-633-2246
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
LAC-18437 (Arizona)
Definition
Definition to come...
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