Russell, Delisa Duncan
Russell, Delisa Duncan is an sole proprietor health care provider with primary practice located at 147 W Sunset Rd Ste 101 , San Antonio TX 78209-2681. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Russell, Delisa Duncan can be contacted via phone (210) 725-7716.Contact Information
Primary practice address
147 W Sunset Rd Ste 101
San Antonio TX 78209-2681
Phone: (210) 725-7716
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 15324 | Texas |
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X | 15324 | Texas |
Profile Details
| NPI number | 1568501187 |
|---|---|
| LBN Legal business name | Russell, Delisa Duncan |
| Credentials | LPC-S |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 6th, 2007 |
| Last updated | Jan 22nd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568501187 | NPPES |
| Texas | MEDICAID | 1529836-01 |
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