Stacy Russell, LPCC | |
2265 Como Ave, Saint Paul, MN 55108-1737 | |
(651) 645-5323 | |
Not Available |
Full Name | Stacy Russell |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 2265 Como Ave, Saint Paul, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1336344472 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | CC00781 (Minnesota) | Primary |
Entity Name | Emily Program Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1528165065 PECOS PAC ID: 5193623254 Enrollment ID: O20031229000014 |
Mailing Address | Practice Location Address |
---|---|
Stacy Russell, LPCC 2265 Como Ave, Saint Paul, MN 55108-1737 Ph: (651) 645-5323 | Stacy Russell, LPCC 2265 Como Ave, Saint Paul, MN 55108-1737 Ph: (651) 645-5323 |
Yvette Anderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 762 Transfer Rd Ste 21, Saint Paul, MN 55114 Phone: 218-355-8978 | |
Miss Kelly Pertzsch, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 2265 Como Ave, Saint Paul, MN 55108 Phone: 651-645-5325 Fax: 651-379-6141 | |
Abigail Brown, MA, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1246 University Ave W, Saint Paul, MN 55104 Phone: 651-404-2000 | |
Pang Xiong, Counselor Medicare: Medicare Enrolled Practice Location: 451 Lexington Pkwy N, Saint Paul, MN 55104 Phone: 651-280-2310 Fax: 651-280-3995 | |
Ms. Elizabeth Subramaniam, MA Counselor Medicare: Not Enrolled in Medicare Practice Location: 658 Grand Ave, Saint Paul, MN 55105 Phone: 612-920-2030 | |
Kyle Lipinski, MSS, LADC Counselor Medicare: Medicare Enrolled Practice Location: 438 Dorothy Day Pl, Saint Paul, MN 55102 Phone: 651-793-2219 | |
Noah Rector, LICSW, LADC, MED. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2353 Rice St, Saint Paul, MN 55113 Phone: 612-979-2683 |