Mr Cory Anthony Russell, LPCI in Allendale, SC

Mr Cory Anthony Russell, LPCI is a medicare enrolled "Counselor - Mental Health" provider in Allendale, South Carolina. His current practice location is 438 Barnwell Rd, Allendale, South Carolina. You can reach out to his office (for appointments etc.) via phone at (803) 584-4636.

Mr Cory Anthony Russell is licensed to practice in South Carolina (license number 6131) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720498785.

Contact Information

	Mr Cory Anthony Russell, LPCI
	438 Barnwell Rd, Allendale, SC 29810
	(803) 584-4636
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Cory Anthony Russell
Gender	Male
Speciality	Counselor - Mental Health
Location	438 Barnwell Rd, Allendale, South Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720498785
Provider Enumeration Date: 04/30/2014
Last Update Date: 05/09/2025

Medicare PECOS Information:

PECOS PAC ID: 9739607730
Enrollment ID: I20250514000149

Medical Identifiers

Medical identifiers for Mr Cory Anthony Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720498785	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	6131 (South Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Cory Anthony Russell allows following entities to bill medicare on his behalf.

Entity Name	Lifesource Of North Carolina
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972861789 PECOS PAC ID: 7416132428 Enrollment ID: O20120801000901

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Cory Anthony Russell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Cory Anthony Russell, LPCI 1050 Ribaut Rd, Beaufort, SC 29902-5400 Ph: (843) 524-8899	Mr Cory Anthony Russell, LPCI 438 Barnwell Rd, Allendale, SC 29810 Ph: (803) 584-4636

Reviews and Comments

Counselor in Allendale, SC

Christina Ann Cartagena, LPC Counselor Medicare: Medicare Enrolled Practice Location: 189 Spruce St, Allendale, SC 29810 Phone: 803-702-9028
Christy Jinks, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 603 Barnwell Rpad, Allendale, SC 29810 Phone: 803-584-4636
James Freeman, Counselor Medicare: Not Enrolled in Medicare Practice Location: 603 Barnwell Road, Allendale, SC 29810 Phone: 803-584-4636
Yulandar Sue Simmons, Counselor Medicare: Not Enrolled in Medicare Practice Location: 355 Pearl St, Allendale, SC 29810 Phone: 863-314-7402
Paula Priester, Counselor Medicare: Not Enrolled in Medicare Practice Location: 279 Hickory St S, Allendale, SC 29810 Phone: 803-573-7104 Fax: 803-573-7105
India Curry, Counselor Medicare: Not Enrolled in Medicare Practice Location: 603 Barnwell Hwy, Allendale, SC 29810 Phone: 803-584-4636

Mr Cory Anthony Russell, LPCI - Medicare Counselor in Allendale, SC