Organization
BETHANY R. RUSSELL, PH.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BETHANY R RUSSELL PH.D., LMHC (PRESIDENT)
(239) 427-1635
Entity
Organization
Contact information
Practice address
44177 KELLY DR, BABCOCK RANCH, FL 33982-5372
(239) 427-1635
Mailing address
44177 KELLY DR, BABCOCK RANCH, FL 33982-5372
(239) 427-1635
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QR1100X
Research Clinic/Center
—
—
Other
Enumeration date
02/13/2026
Last updated
02/13/2026
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