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Organization
WHITE COUNTY COMMUNITY COUNSELING SERVICES LLC
Active
Organization
WHITE COUNTY COMMUNITY COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD CHARLES RUSSELL LMHC (DIRECTOR)
(574) 583-8055
Entity
Organization
Contact information
Practice address
126 S MAIN ST, MONTICELLO, IN 47960
(574) 583-8055
Mailing address
126 S MAIN ST, MONTICELLO, IN 47960
(574) 583-8055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002487A
IN
101YP2500X
Professional Counselor
39002487A
IN
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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