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Individual

STEPHANIE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC, LCAC, NCC, CCT

Contact information

Practice address
809 ELMHURST BLVD, SALINA, KS 67401-7405
(785) 823-6322
(785) 823-3109
Mailing address
809 ELMHURST BLVD, SALINA, KS 67401
(785) 823-6322
(785) 823-3109

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
008
KS
101YP2500X
Professional Counselor
Primary
2680
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30004309210001
KS
Enumeration date
01/23/2013
Last updated
04/03/2024
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