Individual
MR. RICHARD CHARLES RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
126 S MAIN ST, MONTICELLO, IN 47960-2328
(574) 583-8055
Mailing address
126 S MAIN ST, MONTICELLO, IN 47960-2328
(574) 583-8055
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39002487A
IN
101YP2500X
Professional Counselor
39002487A
IN
Other
Enumeration date
01/09/2009
Last updated
06/13/2013
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