Individual
BETHANY ANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
121 N GEM TRL APT 10, FAYETTEVILLE, AR 72701-7380
(501) 454-9589
Mailing address
121 N GEM TRL APT 10, FAYETTEVILLE, AR 72701-7380
(501) 454-9589
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
AR
Other
Enumeration date
04/28/2026
Last updated
04/28/2026
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