Individual provider · Type 1 NPI

Shelly Dawn Russell, LCDCIII.162408

Addiction (Substance Use Disorder) Counselor · Coal Grove, OH

NPI number 1679055719 Active

Practice location

323 Marion Pike Ste 1
Coal Grove, OH 45638-2958

Call (740) 237-4981 Map

Fax (877) 325-2816

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XLCDCIII.162408 (OH)

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About NPI 1679055719

Shelly Dawn Russell, LCDCIII.162408's National Provider Identifier is 1679055719, issued on Sep 5, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Coal Grove, OH. The record was last updated on Jun 3, 2025.