Richard, Russell
Richard, Russell is an sole proprietor health care provider with primary practice located at 333 Dr Michael Debakey Dr Ste 220 , Lake Charles LA 70601-5888. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Richard, Russell can be contacted via phone (337) 478-9331.Contact Information
Primary practice address
333 Dr Michael Debakey Dr Ste 220
Lake Charles LA 70601-5888
Phone: (337) 478-9331
Fax: (337) 478-9828
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 29286 | Texas |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 14219 | Louisiana |
Profile Details
NPI number | 1992856652 |
---|---|
LBN Legal business name | Richard, Russell |
Credentials | |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 16th, 2007 |
Last updated | Oct 25th, 2022 - about 2 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 | 1992856652 | NPPES |
Louisiana | MEDICAID | 2443640 | |
Louisiana | MEDICAID | 3885727 | |
Louisiana | MEDICAID | 144384801 |
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