Individual
CHASITY TIERRA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
2290 N RONALD REAGAN BLVD STE 116, LONGWOOD, FL 32750-3534
(407) 215-0095
Mailing address
2290 N RONALD REAGAN BLVD STE 116, LONGWOOD, FL 32750-3534
(407) 215-0095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH23676
FL
Other
Enumeration date
08/29/2024
Last updated
10/13/2025
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