Individual
MARQUITA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-A
Contact information
Practice address
2020 REMOUNT RD STE G100, GASTONIA, NC 28054-7476
(980) 258-9315
Mailing address
2020 REMOUNT RD STE G100, GASTONIA, NC 28054-7476
(980) 258-9315
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P023302
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
01/23/2026
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