| Gary Lee Russell, LPCC-S, LICDC | |
|
151 Marion Ave, Mansfield, OH 44903-2223 | |
| (419) 774-9969 | |
| Not Available |
| Full Name | Gary Lee Russell |
|---|---|
| Gender | Male |
| Speciality | Counselor - Mental Health |
| Location | 151 Marion Ave, Mansfield, Ohio |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003394180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | LICDC.162577 (Ohio) | Secondary |
| 101YM0800X | Counselor - Mental Health | E.2001844-SUPV (Ohio) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gary Lee Russell, LPCC-S, LICDC 33 S Lexington Springmill Rd, Ontario, OH 44906-1325 Ph: (419) 528-8008 | Gary Lee Russell, LPCC-S, LICDC 151 Marion Ave, Mansfield, OH 44903-2223 Ph: (419) 774-9969 |
Elizabeth A Dean, CDCA Counselor Medicare: Not Enrolled in Medicare Practice Location: 680 Park Ave W, Mansfield, OH 44906 Phone: 419-528-5993 Fax: 568-560-5483 | |
Debora Van Romer, LPC Counselor Medicare: Medicare Enrolled Practice Location: 151 Marion Ave, Mansfield, OH 44903 Phone: 419-774-9969 Fax: 419-756-5642 | |
Wesley Kyser, LISW-S, LICDC Counselor Medicare: Not Enrolled in Medicare Practice Location: 2 Smith Ave, Mansfield, OH 44905 Phone: 419-982-2400 | |
Stevanie Brown, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 151 Marion Ave, Mansfield, OH 44903 Phone: 419-774-9969 | |
Aloys Kamwithi, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 270 Sterkel Blvd, Mansfield, OH 44907 Phone: 419-756-1133 Fax: 419-756-7456 | |
Jessica L Luttrell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 780 Park Ave W, Mansfield, OH 44906 Phone: 419-709-8103 |