Victor Jones Russell, LCAS, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0558 Issued in NC

Practice address

116 W Main St
Wallace, NC 28466-2902

Phone

(910) 285-5527

Fax

(910) 285-5526

NPI assigned

Feb 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Sharita Lawson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164563417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 SPRING DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285409161",
            "telephone_number": "910-285-5527",
            "fax_number": "910-285-5526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 W MAIN ST",
            "city": "WALLACE",
            "state": "NC",
            "postal_code": "284662902",
            "telephone_number": "910-285-5527",
            "fax_number": "910-285-5526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "VICTOR",
        "middle_name": "JONES",
        "credential": "LCAS, CSAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "0558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARITA",
            "last_name": "LAWSON",
            "prefix": "MRS.",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Realo Discount Drug Stores of Eastern North Carolina, Inc (Realo Discount Drugs)
• Daniel Michael Ricci, M.D.
• Donna Roberts Rice, RPH
• J Daniel Robinson III, OD
• Carrie Kyper Royer, PA-C
• RX Medeq LLC
• Scottie Drugs of Wallace Inc (Scottie Drug Stores)
• Haley Shand
• Axon Darren Sholar, DDS
• Claudia Compton Smith, N.P.

• Addiction (Substance Use Disorder) Counselor in Wallace, NC
• Providers in Wallace, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.