David Lee Russell in Portage - Psychologist
David Lee Russell - NPI 1548362171
David Lee Russell is a Psychologist in Portage, Michigan. David Lee Russell practices all healthcare services and medical treatments related to Psychologist. The NPI Number for David Lee Russell is 1548362171. The last update date is 2008-02-08.
David Lee Russell's current location address is Po Box 2585, Portage, Michigan. You can contact this provider via phone number 2693810150 and fax number 2693734720. The mailing address for David Lee Russell is Po Box 2585, Portage, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David Lee Russell |
|---|---|
| Address | Po Box 2585, Portage, Michigan |
| Phone Number | 2693810150 |
| Fax Number | 2693734720 |
| Sole Proprietor | N |
| Credentials | ED.D. |
NPI Number Detail
| NPI Number | 1548362171 |
|---|---|
| Provider Enumeration Date | 2006-09-03 |
| Last Updated Date | 2008-02-08 |
Provider Mailing Address Detail
| Address | Po Box 2585 |
|---|---|
| City | Portage |
| State | Michigan (MI) |
| Post Code | 490812585 |
| Phone Number | 2693810150 |
| Fax Number | 2693734720 |
Provider's Primary Taxonomy Detail
| Speciality | Psychologist |
|---|---|
| Taxonomy | 103T00000X |
| Licence No | 6301006163 |
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Definition: A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and proce |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| OC910420 | BCBS | ||
| OC94582 | BCBS |
Post Comment/ Review Below
What is the unique identifier code issued to David Lee Russell by the Centers for Medicare & Medicaid Services (CMS)?
The David Lee Russell has been assigned the NPI (National Provider Identifier) 1548362171. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where David Lee Russell is located?
The David Lee Russell is situated at the following address: Po Box 2585, Portage, MI, 490812585.
What is the David Lee Russell's specialty and taxonomy code?
The David Lee Russell's specialty is Psychologist, and the corresponding taxonomy code is 103T00000X.
On what date did the David Lee Russell receive its 1548362171 assignment from the Centers for Medicare & Medicaid Services?
The David Lee Russell was assigned its 1548362171 by the Centers for Medicare & Medicaid Services on 2006-09-03.
When was the information related to David Lee Russell most recently updated or refreshed?
The details pertaining to the David Lee Russell, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-02-08.
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