CONNIE RUSSELL CSAC NPI 1447691167

NPI Information

NPI: 1447691167
Provider Name: CONNIE RUSSELL, CSAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
712 55TH ST
KENOSHA, WI
ZIP 53140
Phone: (262) 842-0538
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Connie Russell, CSAC is an addiction (substance use disorder) counselor in Kenosha, WI. Connie Russell, CSAC NPI is 1447691167. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

712 55TH ST
KENOSHA, WI
ZIP 53140-506
Phone: (262) 842-0538

The enumeration date for this NPI number is 7/10/2013 and was last updated on 7/11/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	1915-132	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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