Russell, Stephen Trey

Russell, Stephen Trey is an individual health care provider with primary practice located at 1849 Lamar Ave Ste 120 , Paris TX 75460-1463. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Russell, Stephen Trey can be contacted via phone (903) 715-4480.

Contact Information

Primary practice address
1849 Lamar Ave Ste 120 Paris TX 75460-1463
Phone: (903) 715-4480
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1093059974
LBN Legal business name Russell, Stephen Trey
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2012
Last updated Jul 11th, 2019 - about 7 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 1093059974 NPPES
Texas MEDICAID 352276504

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