Individual
SCARLETT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN/QMHP-R
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
25-QMP-R-3611
OR
163W00000X
Registered Nurse
10041531
OR
163WC0400X
Case Management Registered Nurse
Primary
10041531
OR
Other
Enumeration date
05/27/2025
Last updated
07/02/2025
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