Shannon L Russell, | |
14 Fordham Rd, Allston, MA 02134-3006 | |
(617) 782-6460 | |
Not Available |
Full Name | Shannon L Russell |
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Gender | Female |
Speciality | Counselor |
Location | 14 Fordham Rd, Allston, Massachusetts |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1720414238 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Primary |
Entity Name | Rollins Counseling Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083220206 PECOS PAC ID: 8426460908 Enrollment ID: O20201208001412 |
Mailing Address | Practice Location Address |
---|---|
Shannon L Russell, 14 Fordham Rd, Allston, MA 02134-3006 Ph: (617) 782-6460 | Shannon L Russell, 14 Fordham Rd, Allston, MA 02134-3006 Ph: (617) 782-6460 |
Joseph Domnic Accardi, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 | |
Karina F Evora, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 | |
Steven Vance Walker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 | |
Emma Nance, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 | |
Alissa Jane Romanow, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 | |
Nicole Wolff, Counselor Medicare: Not Enrolled in Medicare Practice Location: 239 Kelton St, 41, Allston, MA 02134 Phone: 617-997-8129 | |
Cassandra Summers, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14 Fordham Rd, Allston, MA 02134 Phone: 617-782-6460 |