| Lisa Parkes Russell, LPC | |
|
15290 Russell Dr, Onancock, VA 23417-3004 | |
| (757) 710-0550 | |
| Not Available |
| Full Name | Lisa Parkes Russell |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 15290 Russell Dr, Onancock, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225888225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0701013402 (Virginia) | Primary |
| Entity Name | Clinical Associates Of Tidewater |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447341615 PECOS PAC ID: 4981688744 Enrollment ID: O20040617001131 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Parkes Russell, LPC 15290 Russell Dr, Onancock, VA 23417-3004 Ph: (757) 710-0550 | Lisa Parkes Russell, LPC 15290 Russell Dr, Onancock, VA 23417-3004 Ph: (757) 710-0550 |
Gary N Wilkerson, M.ED Counselor Medicare: Not Enrolled in Medicare Practice Location: 33 Boundary Ave, Onancock, VA 23417 Phone: 267-258-3894 Fax: 757-709-7052 | |
Ilene Ann Richardson, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 15262 Russell Dr, Onancock, VA 23417 Phone: 410-713-0709 Fax: 410-546-0264 | |
Lynne Elliott Saunders, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14419 Matchotank Rd, Onancock, VA 23417 Phone: 757-607-6197 |