Individual
CASEY LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSC-AD
Contact information
Practice address
1113 HEALTHWAY DR, SALISBURY, MD 21804-4470
(410) 334-6961
(410) 334-6362
Mailing address
1113 HEALTHWAY DR, SALISBURY, MD 21804-4470
(410) 334-6961
(410) 334-6362
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC1605
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
520202702
—
MD
05
—
525202700
—
MD
Enumeration date
11/29/2011
Last updated
04/18/2018
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