Individual
MR. RUSSEL DAMIEN BUSKIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCDP
Contact information
Practice address
410 FOULK RD, SUITE 105, WILMINGTON, DE 19803-3820
(302) 762-2285
(302) 762-2286
Mailing address
7 ROCKFORD RD APT A2, WILMINGTON, DE 19806-1006
(302) 220-6825
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CD-0000006
DE
1041C0700X
Clinical Social Worker
Primary
Q1-0000697
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006603272
BUSINESS LICENSE
DE
Enumeration date
02/04/2007
Last updated
09/25/2012
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