MISS Crystal M Russell, LPCC, CDCA

NPI #1538542097 in Ontario, Ohio

Provider Information

NPI Number: 1538542097
Entity Type: Individual
Name: MISS Crystal M Russell, LPCC, CDCA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Credential: LPCC, CDCA
Enumeration Date: Jul 1, 2015
Last Updated: Jul 21, 2022

Practice Location

Address: 1338 W 4TH ST
City: Ontario
State: Ohio
ZIP Code: 44906-1828
Phone: (419) 528-5994

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Student in an Organized Health Care Education/Training Program	390200000X

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