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General NPI Number Information
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NPI Number | 1154000511
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Entity Type | Individual
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Provider Name | ZACHARY FARRINGTON RUSSELL LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/13/2023
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1903 N HARRISON AVE STE 100
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City | CARY
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State | NC
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Zip | 27513-3003
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Country | US
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Telephone | 203-581-0920
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 E BROAD ST STE 127
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-1968
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Country | US
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Telephone | 203-581-0920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C019232
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License Number State | NC
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