Russell, Brian
Russell, Brian is an individual health care provider with primary practice located at 4823 N Royal Atlanta Dr C, Tucker GA 30084-3806. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Russell, Brian can be contacted via phone (770) 939-2121.Contact Information
Primary practice address
4823 N Royal Atlanta Dr C
Tucker GA 30084-3806
Phone: (770) 939-2121
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 55815 | Texas |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | CSW004391 | Georgia |
Profile Details
| NPI number | 1407078603 |
|---|---|
| LBN Legal business name | Russell, Brian |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | Feb 20th, 2015 - about 9 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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