Russell, Thomas

Russell, Thomas is an individual health care provider with primary practice located at 3780 Kilroy Airport Way , Long Beach CA 90806-2457. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Russell, Thomas can be contacted via phone (562) 424-6015.

Contact Information

Primary practice address
3780 Kilroy Airport Way Long Beach CA 90806-2457
Phone: (562) 424-6015
Fax: (562) 988-6897
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 94020370 California
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 94020370 California
Behavioral Health & Social Service Providers / School 103TS0200X 101067938 California
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 76881 California

Profile Details

NPI number 1639579675
LBN Legal business name Russell, Thomas
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2014
Last updated Aug 27th, 2014 - about 10 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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