Individual provider · Type 1 NPI

Gary Lee Russell, LPCC-S, LICDC

Mental Health Counselor · Mansfield, OH

NPI number 1003394180 Active

Practice location

151 Marion Ave
Mansfield, OH 44903-2223

Call (419) 774-9969 Map

Mailing address

33 S Lexington Springmill Rd
Ontario, OH 44906-1325

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XLICDC.162577 (OH)
Mental Health Counselor Primary 101YM0800XE.2001844-SUPV (OH)

Mental Health Counselor: Definition to come...

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About NPI 1003394180

Gary Lee Russell, LPCC-S, LICDC's National Provider Identifier is 1003394180, issued on Aug 1, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Mansfield, OH. The record was last updated on Feb 15, 2024.