National Provider Identifier
Russ Blackstone
Russ Blackstone is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Buffalo, NY and a listed phone number of (716) 697-7380.
Profile Overview
- NPI
- 1245004910
- Provider Type
- Individual
- Primary Specialty
- Mental Health Counselor
- Enumeration Date
- November 13, 2023
- Last Updated
- June 10, 2024
Practice Location
- 1515 Kensington Ave Ste 103
- Buffalo, NY 14215-1436
Phone: (716) 697-7380
Specialties
- Mental Health Counselor (101YM0800X)
Full Record
- NPI
- 1245004910
- Entity Type
- Individual
- Last Name
- Blackstone
- First Name
- Russ
- Provider Other Last Name
- Blackstone
- Provider Other First Name
- Russell
- Provider Other Middle Name
- H
- Provider Other Credential Text
- LMHC
- Provider Other Last Name Type Code
- 2
- Mailing Street Address
- 1515 Kensington Ave Ste 103
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14215-1436
- Mailing Country
- US
- Mailing Phone
- (716) 697-7380
- Practice Street Address
- 1515 Kensington Ave Ste 103
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14215-1436
- Practice Country
- US
- Practice Phone
- (716) 697-7380
- Enumeration Date
- November 13, 2023
- Last Updated
- June 10, 2024
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- June 10, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Mental Health Counselor (101YM0800X)