Individual
CAISIE MADISON RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
111 E MAIN ST STE B, ELKTON, MD 21921-5996
(443) 406-3234
Mailing address
290 W CLAIBORNE RD APT 303, NORTH EAST, MD 21901-3449
(443) 306-6162
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2415
MD
1041C0700X
Clinical Social Worker
Primary
28593
MD
Other
Enumeration date
05/18/2021
Last updated
02/12/2025
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