Individual
MR. PAUL A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4236 W PHELPS RD, LAKE CITY, MI 49651-9338
(616) 215-2231
Mailing address
4236 W PHELPS RD, LAKE CITY, MI 49651-9338
(616) 215-2231
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401012403
MI
Other
Enumeration date
06/02/2011
Last updated
04/16/2025
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