Russell, Doris M

Russell, Doris M is an individual health care provider with primary practice located at 100 Ledgehill Rd , Bennington VT 05201-2273. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Russell, Doris M can be contacted via phone (802) 442-5491.

Contact Information

Primary practice address
100 Ledgehill Rd Bennington VT 05201-2273
Phone: (802) 442-5491
Fax: (802) 442-3363
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 048-0000574 Vermont
Behavioral Health & Social Service Providers / Clinical 103TC0700X 048-0000574 Vermont

Profile Details

NPI number 1134140635
LBN Legal business name Russell, Doris M
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Oct 2nd, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134140635 NPPES
Other 29292 BLUE CROSS
Other 1047191 BLUE CROSS
MEDICAID 0VN0552 BLUE CROSS
Other 10022260 BLUE CROSS
Other 359506 BLUE CROSS

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