Individual
JOYCE RUSSELL-ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
(718) 948-3232
(718) 966-6605
Mailing address
3911 RICHMOND AVE, STATEN ISLAND, NY 10312-5110
(718) 948-3232
(718) 966-6605
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
072444-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07209
—
NY
Enumeration date
07/11/2013
Last updated
07/11/2013
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