Individual
DAVID PATRICK RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT, LMHC
Contact information
Practice address
800 MAIN ST, HOLDEN, MA 01520-1838
(508) 829-4242
Mailing address
102 JACKSON ST, JEFFERSON, MA 01522-1413
(508) 366-4000
(508) 870-9991
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3364
MA
106H00000X
Marriage & Family Therapist
887
MA
Other
Enumeration date
08/31/2006
Last updated
11/05/2019
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