Chumley, Russell

Chumley, Russell is an sole proprietor health care provider with primary practice located at 4579 South Eason Boulevard , Tupelo MS 38801. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Chumley, Russell can be contacted via phone (662) 377-3115.

Contact Information

Primary practice address
4579 South Eason Boulevard Tupelo MS 38801
Phone: (662) 377-3115
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0481 Mississippi
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X T0358 Mississippi

Profile Details

NPI number 1144636598
LBN Legal business name Chumley, Russell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2014
Last updated Jul 7th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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