Russell, Stanley Wayne
Russell, Stanley Wayne is an sole proprietor health care provider with primary practice located at 4625 Beckley Rd Suite 300, Battle Creek MI 49015-7948. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Russell, Stanley Wayne can be contacted via phone (269) 979-8119.Contact Information
Primary practice address
4625 Beckley Rd Suite 300
Battle Creek MI 49015-7948
Phone: (269) 979-8119
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 6401010247 | Michigan |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 6401010247 | Michigan |
| Behavioral Health & Social Service Providers / Pastoral | 101YP1600X | 6401010247 | Michigan |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 6401010247 | Michigan |
Profile Details
| NPI number | 1366642761 |
|---|---|
| LBN Legal business name | Russell, Stanley Wayne |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 23rd, 2007 |
| Last updated | Feb 2nd, 2017 - about 8 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 | 1366642761 | NPPES |
| Michigan | Other | 6401010247 | STATE OF MICHIGAN LICENSED PROFESSIONAL COUNSELOR |
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