Provider Demographics
NPI:1447886833
Name:RUSSELL, WHITNEY ASHA (CNA, CSAC-A)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:ASHA
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:CNA, CSAC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 RAINTREE RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1259
Mailing Address - Country:US
Mailing Address - Phone:434-429-4547
Mailing Address - Fax:
Practice Address - Street 1:1555 MEADOWVIEW DR STE 5
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-7352
Practice Address - Country:US
Practice Address - Phone:434-685-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-17
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)