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Miss Crystal M Russell, LPCC,CDCA
Student in an Organized Health Care Education/Training Program in Ontario, Ohio
NPI 1538542097

Crystal M Russell is a Student in an Organized Health Care Education/Training Program based in Mansfield, OH. Crystal M Russell practices in Ontario, OH and has the professional credentials of LPCC,CDCA. The NPI Number for Crystal M Russell is 1538542097 and holds a License No. C15000630 (Ohio).

The current practice location address for Crystal M Russell is 1338 W 4Th St, Ontario, OH and can be reached out via phone at 419-528-5994.

Location: 1338 W 4Th St, Ontario, OH, 44907-1911
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538542097
Provider Name
Crystal M Russell
Credential
LPCC,CDCA
Provider Entity Type
Individual
Gender
Female
Address
1338 W 4Th St, Ontario, OH, 44907-1911
Phone Number
419-528-5994
Fax Number
Provider Enumeration Date
07/01/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1338 W 4Th St
City
Ontario
State
Ohio
Zip
44906-1828
Phone Number
419-528-5994
Fax Number
person
Provider Business Mailing Address Details
Address
1338 W 4Th St
City
Ontario
State
Ohio
Zip
44906-1828
Phone Number
419-528-5994
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
E.2102678 (Ohio)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
C1500630 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
CDCA162724 (Ohio)
Definition
Definition to come...
person
Provider's Taxonomy Details 4
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
C15000630 (Ohio)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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