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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568501187 NPPES
Texas MEDICAID 1529836-01

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