Provider Demographics
NPI:1457536880
Name:ENRIGHT, RUSSELL ANTHONY (MC)
Entity Type:Individual
Prefix:MR
First Name:RUSSELL
Middle Name:ANTHONY
Last Name:ENRIGHT
Suffix:
Gender:M
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14350 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:SIUTE #2
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-8843
Mailing Address - Country:US
Mailing Address - Phone:480-477-7663
Mailing Address - Fax:
Practice Address - Street 1:14350 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:SIUTE #2
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-8843
Practice Address - Country:US
Practice Address - Phone:480-477-7663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 12385101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional