Russell W Dern is a Clinical in Lebanon, Ohio. Russell W Dern practices all healthcare services and medical treatments related to Clinical. The NPI Number for Russell W Dern is 1568438497. The last update date is 2018-05-22.
Russell W Dern's current location address is 204 Cook Rd, Lebanon, Ohio. You can contact this provider via phone number 5132287800 and fax number 5137252231. The mailing address for Russell W Dern is 204 Cook Rd, Lebanon, Ohio. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Russell W Dern |
|---|---|
| Address | 204 Cook Rd, Lebanon, Ohio |
| Phone Number | 5132287800 |
| Fax Number | 5137252231 |
| Sole Proprietor | N |
| Credentials | PH.D |
NPI Number Detail
| NPI Number | 1568438497 |
|---|---|
| Provider Enumeration Date | 2006-02-28 |
| Last Updated Date | 2018-05-22 |
Provider Mailing Address Detail
| Address | 204 Cook Rd |
|---|---|
| City | Lebanon |
| State | Ohio (OH) |
| Post Code | 450369600 |
| Phone Number | 5132287800 |
| Fax Number | 5137252231 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | 3444 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 11489916 | OH | CAQH | |
| 630884 | OH | -- | |
| 12343 | OH | ANTHEM PIN |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Russell W Dern by the Centers for Medicare & Medicaid Services?
The Russell W Dern has been issued the NPI (National Provider Identifier) 1568438497 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Russell W Dern is located?
The Russell W Dern is situated at the following address: 204 Cook Rd, Lebanon, OH, 450369600.
What is Russell W Dern's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Russell W Dern is Clinical, and the corresponding taxonomy classification code for this specialized field is 103Tc0700X.
On what date was the 1568438497 assigned to Russell W Dern?
The Russell W Dern was issued its 1568438497 on 2006-02-28, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the Russell W Dern's details last updated?
The information pertaining to the Russell W Dern, including its address, specialty, and other details, was most recently updated on 2018-05-22.
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