| Etienne Fox Logan Ii, | |
|
1258 Holland Rd, Suffolk, VA 23434-6313 | |
| (757) 809-4771 | |
| (757) 809-4932 |
| Full Name | Etienne Fox Logan Ii |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1258 Holland Rd, Suffolk, Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346712478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 0732005011 (Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Etienne Fox Logan Ii, 55 Beattie Pl Ste 810, Greenville, SC 29601-2191 Ph: (864) 527-3145 | Etienne Fox Logan Ii, 1258 Holland Rd, Suffolk, VA 23434-6313 Ph: (757) 809-4771 |
Chaniece Winfield, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 135 S Saratoga St, Suffolk, VA 23434 Phone: 757-842-0542 | |
Megan Lea Johnson, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 707 Gittings St Ste 120, Suffolk, VA 23434 Phone: 757-514-3248 | |
Hannah Alyse Andrews, Counselor Medicare: Not Enrolled in Medicare Practice Location: 318 Baron Blvd, Suffolk, VA 23435 Phone: 757-992-8910 | |
Satrina Artis, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1000 Commercial Ln, Suffolk, VA 23434 Phone: 757-925-2484 Fax: 757-925-2205 | |
Arielle Shipp, LPC, PMH-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 Clay St, Suffolk, VA 23434 Phone: 757-965-8663 Fax: 757-539-8834 | |
Ashley Lynn Bianchini, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2790 Godwin Blvd Ste 210, Suffolk, VA 23434 Phone: 513-834-7063 | |
Mrs. Ashanti Courtney Conner, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7025 Harbour View Blvd Ste 119, Suffolk, VA 23435 Phone: 757-274-2836 Fax: 757-673-2586 |