Individual provider · Type 1 NPI

Keith Russell

Professional Counselor · Philadelphia, PA

NPI number 1952009458 Active

Practice location

1329 N 56th St
Philadelphia, PA 19131-4225

Call (267) 258-1568 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000XNone listed
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed
Professional Counselor Primary 101YP2500XNone listed

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About NPI 1952009458

Keith Russell's National Provider Identifier is 1952009458, issued on Feb 23, 2023. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Philadelphia, PA. The record was last updated on Feb 23, 2023.