Individual provider · Type 1 NPI
Wanda J. Russell, LMHC
Mental Health Counselor · Lily Dale, NY
NPI number
1972870202
Active
Practice location
PO Box 121, 19 First Street
Lily Dale, NY 14752-0121
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 014700 (NY) |
| Professional Counselor | 101YP2500X | EPPNJJV6 (PA) |
Mental Health Counselor: Definition to come...
About NPI 1972870202
Wanda J. Russell, LMHC's National Provider Identifier is 1972870202, issued on Dec 1, 2011. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lily Dale, NY. The record was last updated on Jul 17, 2026.