Individual
CARRIE H RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 605-6150
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-0001
(603) 605-6150
Taxonomy
Speciality
Code
Description
License number
State
101YS0200X
School Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
2223
NH
1041C0700X
Clinical Social Worker
LCSW 214798
MA
1041C0700X
Clinical Social Worker
LW60316853
WA
Other
Enumeration date
12/19/2007
Last updated
09/14/2021
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