Individual
MRS. JOAN ELLEN RUSSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
54 E LEE ST, WARRENTON, VA 20186
(540) 347-0613
(540) 347-0768
Mailing address
54 E LEE ST, WARRENTON, VA 20186
(540) 347-0613
(540) 347-0768
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904006197
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010244897
—
VA
01
—
07260017
CARE FIRST
—
01
—
188908
ANTHEM
—
01
—
827983000
MAGELLAN
—
Enumeration date
10/25/2006
Last updated
06/18/2008
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