Provider Demographics
NPI:1083398028
Name:DAVID RUSSELL COMPANY
Entity Type:Organization
Organization Name:DAVID RUSSELL COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-200-8518
Mailing Address - Street 1:PO BOX 23321
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-3321
Mailing Address - Country:US
Mailing Address - Phone:406-200-8518
Mailing Address - Fax:406-794-0206
Practice Address - Street 1:1645 PARKHILL DR STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3067
Practice Address - Country:US
Practice Address - Phone:406-200-8518
Practice Address - Fax:406-794-0206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty