Christopher Russell, LPC | |
43 Champions Ave, Big Stone Gap, VA 24219-1105 | |
(276) 523-8300 | |
(276) 523-6964 |
Full Name | Christopher Russell |
---|---|
Gender | Male |
Speciality | Counselor - Professional |
Location | 43 Champions Ave, Big Stone Gap, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902393010 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 0701007555 (Virginia) | Primary |
Entity Name | Frontier Health |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720147408 PECOS PAC ID: 2860302320 Enrollment ID: O20040206000424 |
Mailing Address | Practice Location Address |
---|---|
Christopher Russell, LPC 139 2nd Ave W, Big Stone Gap, VA 24219-4178 Ph: (276) 644-7690 | Christopher Russell, LPC 43 Champions Ave, Big Stone Gap, VA 24219-1105 Ph: (276) 523-8300 |
Mr. Mark Harrison Wade, LPC CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3169 2nd Ave E, Big Stone Gap, VA 24219 Phone: 276-523-8300 Fax: 276-523-6964 | |
Mr. James Dale Kegley, MS Counselor Medicare: Not Enrolled in Medicare Practice Location: 3169 2nd Avenue East, Big Stone Gap, VA 24219 Phone: 276-523-8315 Fax: 276-523-6964 | |
Whitney B Trinkle, MED Counselor Medicare: Not Enrolled in Medicare Practice Location: 43 Champions Ave, Big Stone Gap, VA 24219 Phone: 276-523-8300 | |
Mrs. Deborah Lynn Skorupa, Counselor Medicare: Not Enrolled in Medicare Practice Location: 622 Powell Ave, Developmental Services, Big Stone Gap, VA 24219 Phone: 276-523-0682 Fax: 276-523-0684 | |
Sharon Short Shaver, BA Counselor Medicare: Medicare Enrolled Practice Location: 622 Powell Ave E, Big Stone Gap, VA 24219 Phone: 276-523-0682 Fax: 423-467-3644 | |
Claressa Rema Young, BS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2532 4th Avenue East, Big Stone Gap, VA 24219 Phone: 276-523-4357 Fax: 276-523-2527 | |
Michael Sean Halcomb, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 3169 2nd Ave E, Big Stone Gap, VA 24219 Phone: 276-523-8300 Fax: 423-467-3644 |