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Jacob Russell, LAC
NPI 1184799876 · on the registry since 2006
Practice
- Address
- 104 Conniebrook Ln
Melbourne, AR 72556 - Phone
- (870) 258-3305
- Fax
- (870) 258-3244
- Clinicians at this address
- 22
Registry record
- Primary taxonomy
- Professional Counselor
101YP2500X
- Also registered as
- Case Manager/Care Coordinator
- Licence states on file
- AR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-01-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arkansas