Russell, Theresa
Russell, Theresa is an sole proprietor health care provider with primary practice located at 350 N Federal Hwy 715, Boynton Beach FL 33435-4171. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russell, Theresa can be contacted via phone (631) 793-1365.Contact Information
Primary practice address
350 N Federal Hwy 715
Boynton Beach FL 33435-4171
Phone: (631) 793-1365
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW12181 | Florida |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R053958-1 | New York |
Profile Details
| NPI number | 1295266674 |
|---|---|
| LBN Legal business name | Russell, Theresa |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2017 |
| Last updated | Mar 27th, 2017 - about 9 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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