Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACOB G RUSSELL, LAC
ActiveMR. JACOB G RUSSELL, LAC is a Professional Counselor healthcare provider located in MELBOURNE, Arkansas. NPI 1184799876 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · MELBOURNE, AR
Registration Details
- NPI Number
- 1184799876
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 21, 2006 (19.544761463517 yrs)
- Last Updated
- Jan 20, 2011
- License
-
A1101009 (AR)
Practice Information
- Address
-
104 CONNIEBROOK LNMELBOURNE, AR, 725568861Browse AR providers · Browse ZIP 72556
- Phone
- 8702583305
- Fax
- 8702583244
- Primary Specialty
-
Professional Counselor
101YP2500X
- Additional Specialty
- Professional Counselor
Other Professional Counselor Providers in MELBOURNE, AR
| Name | Credential | NPI |
|---|---|---|
| MS. LISA MOXLEY | LPC | 1053489666 |
| MS. CARLA JONES | LPC | 1508060658 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.