Richard, Russell

Richard, Russell is an sole proprietor health care provider with primary practice located at 333 Dr Michael Debakey Dr Ste 220 , Lake Charles LA 70601-5888. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Richard, Russell can be contacted via phone (337) 478-9331.

Contact Information

Primary practice address
333 Dr Michael Debakey Dr Ste 220 Lake Charles LA 70601-5888
Phone: (337) 478-9331
Fax: (337) 478-9828
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 29286 Texas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 14219 Louisiana

Profile Details

NPI number 1992856652
LBN Legal business name Richard, Russell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2007
Last updated Oct 25th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992856652 NPPES
Louisiana MEDICAID 2443640
Louisiana MEDICAID 3885727
Louisiana MEDICAID 144384801

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