IndividualActive
Victor Russell, LCAS, CSAC
NPI 1164563417 · Addiction (Substance Use Disorder) Counselor · Wallace, NC
Provider details
- NPI number
- 1164563417
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- LCAS, CSAC
- Sex
- Male
- Sole proprietor
- No
- License
- 0558 (NC)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
116 W Main St
Wallace, NC 28466-2902
Phone: (910) 285-5527
Fax: (910) 285-5526
Street-level locationGet directions
Mailing address
230 Spring Dr
Jacksonville, NC 28540-9161
Registry dates
- Enumerated
- 2007-02-09
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.