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Contact Information

SUSAN F RUSSELL, PHD,THD, L.AC.,LMSW
4343 SHALLOWFORD RD
SUITE H-5
MARIETTA, GA30062-5023
 Phone: 770-552-4155
 Fax: 770-552-4275
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acupuncturist

171100000X
 

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for SUSAN F RUSSELL · (Female)

NPI # 1558644617
Status Active
Credentials PHD,THD, L.AC.,LMSW
Entity Individual
Enumeration date 09/26/2011
Last updated 09/26/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • GA License # 001798 LMSW
  • GA License # 1798 LMSW
  • GA License # 87
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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