Individual
RUSSELL O'LEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1305 2ND ST S, SUITE 201, NAMPA, ID 83651-3944
(208) 463-0202
(208) 463-0205
Mailing address
1305 2ND ST S STE 201, NAMPA, ID 83651-3964
(208) 463-0202
(208) 463-0205
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LMSW-30901
ID
1041C0700X
Clinical Social Worker
Primary
LCSW-39915
ID
Other
Enumeration date
06/09/2015
Last updated
02/26/2026
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