Provider Demographics
NPI:1407326234
Name:RUSSELL COUNSELING, LLC
Entity Type:Organization
Organization Name:RUSSELL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITINER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:CADY RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LPC
Authorized Official - Phone:503-679-3798
Mailing Address - Street 1:2822 SE SALMON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-4136
Mailing Address - Country:US
Mailing Address - Phone:503-679-3798
Mailing Address - Fax:
Practice Address - Street 1:1942 NW KEARNEY ST STE 32
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1426
Practice Address - Country:US
Practice Address - Phone:503-683-2341
Practice Address - Fax:503-914-1791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-05
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health