Individual
CYNTHIA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1100 K AVE, LA GRANDE, OR 97850-2131
(541) 962-8877
(541) 962-0776
Mailing address
1100 K AVE, LA GRANDE, OR 97850-2131
(541) 962-8877
(541) 962-0776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
A1926
OR
Other
Enumeration date
07/27/2006
Last updated
09/11/2025
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