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General NPI Number Information
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NPI Number | 1407326234
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Entity Type | Organization
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Legal Business Name | RUSSELL COUNSELING
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 1942 NW KEARNEY ST STE 32
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City | PORTLAND
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State | OR
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Zip | 97209-1426
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Country | US
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Telephone | 503-683-2341
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Fax | 503-914-1791
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Provider Business Mailing Address
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Address Line | 2822 SE SALMON ST
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City | PORTLAND
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State | OR
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Zip | 97214-4136
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Country | US
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Telephone | 503-679-3798
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITINER
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Name | MR. MICHAEL LAWRENCE CADY RUSSELL
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Credential | MS, NCC, LPC
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Telephone | 503-679-3798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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