Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Gary Lee Russell, LPCC-S, LICDC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1003394180

Gary Lee Russell, LPCC-S, LICDC is a Mental Health Counselor in Mansfield, Ohio. Qualified in 2002, 24 years ago. Practices as a sole proprietor. Licensed in Ohio.

Years since qualifying
24
Licensed in
OH
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

151 Marion Ave
Mansfield, OH 44903-2223
Phone: (419) 774-9969
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence E.2001844-SUPV (OH)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LICDC.162577 (OH)

Record details

NPI number1003394180
Entity typeIndividual (Type 1)
GenderMale
Credentials LPCC-S , LICDC
Sole proprietorYes
NPI enumeratedAugust 1, 2018
Last updated in NPPESFebruary 15, 2024
Certification dateFebruary 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2002 (24 years in practice)
Accepts Medicare assignment Not indicated

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