Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. TISA BERNALLY-RUSSELL, BSW, LSAA
ActiveAddiction (Substance Use Disorder) Counselor · FARMINGTON, NM
Registration Details
- NPI Number
- 1972933844
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 13, 2013 (12.438645482927 yrs)
- Last Updated
- Nov 13, 2013
- License
-
0160331 (NM)
Practice Information
- Address
-
101 W BROADWAYSUITE DFARMINGTON, NM, 874016419Browse NM providers · Browse ZIP 87401
- Phone
- 5053274796
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in FARMINGTON, NM
| Name | Credential | NPI |
|---|---|---|
| MS. JOLENE M. SCHNEIDER | LADAC | 1376563049 |
| KRISTA LEIGH RAINWATER | LPC | 1528150323 |
| ERNESTINE PLATERO | LSAA | 1710020300 |
| MARC S. BROADWAY | B.A., SAA | 1043342496 |
| MR. MARK SANCHEZ | LADAC,LCDC,ICADC,CAC | 1083735997 |
| TINA J JOHN | — | 1902013808 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.