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Individual

NORMAN CLAY RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC CCS

Contact information

Practice address
7060 PRAIRIE RD # 593, WINNSBORO, LA 71295-2951
(318) 805-4775
(318) 435-7063
Mailing address
7060 PRAIRIE RD # 593, WINNSBORO, LA 71295-2951
(318) 805-4775
(318) 435-7063

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1626
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LA
101YP1600X
Pastoral Counselor
1626
LA
171M00000X
Case Manager/Care Coordinator
1626
LA

Other

Enumeration date
02/13/2023
Last updated
02/13/2023
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