Doctor Name: | CHRIS S RUSSELL |
NPI Number: | 1568549806 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC, LMFT |
License Number: | 4166 |
Business Practice Address: | 1701 River Run Suite 1002 Fort Worth, TX - 761076579 |
Business Phone Number: | 8173770818 |
Business Fax Number: | 8173361740 |
Mailing Address: | 4708 Driskell Blvd, FORT WORTH |
State: | TX |
Postal Code: | 761077213 |
Phone Number: | 8173770818 |
Fax Number: | 8173361740 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 4166 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |