Gray, Russell Clinton

Gray, Russell Clinton is an individual health care provider with primary practice located at 37 Eagle Way , West Chazy NY 12992-2562. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Gray, Russell Clinton can be contacted via phone (518) 563-8035.

Contact Information

Primary practice address
37 Eagle Way West Chazy NY 12992-2562
Phone: (518) 563-8035
Fax: (518) 563-8087
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X R069891-1 New York
Behavioral Health & Social Service Providers / School 1041S0200X 011929001 New York

Profile Details

NPI number 1144524885
LBN Legal business name Gray, Russell Clinton
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 10th, 2011
Last updated Jan 10th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers