Fast, Russell R
Fast, Russell R is an individual health care provider with primary practice located at 1679 6Th Ave W , Dickinson ND 58601-2904. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fast, Russell R can be contacted via phone (701) 483-1000.Contact Information
Primary practice address
1679 6Th Ave W
Dickinson ND 58601-2904
Phone: (701) 483-1000
Fax: (701) 483-1001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2212 | North Dakota |
Profile Details
| NPI number | 1578593026 |
|---|---|
| LBN Legal business name | Fast, Russell R |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 3rd, 2006 |
| Last updated | Feb 13th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578593026 | NPPES |
| North Dakota | MEDICAID | 1455118 | |
| North Dakota | Other | 12990 |
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