Individual
JONATHAN H RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCA
Contact information
Practice address
268 SUNNYSIDE AVE, OAKVILLE, CT 06779-1438
(914) 539-5993
Mailing address
268 SUNNYSIDE AVE, OAKVILLE, CT 06779-1438
(914) 539-5993
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8346
CT
Other
Enumeration date
05/22/2025
Last updated
05/22/2025
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