Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Tisa Bernally-Russell, BSW, LSAA

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1972933844

Mrs. Tisa Bernally-Russell, BSW, LSAA is an Addiction (Substance Use Disorder) Counselor in Farmington, New Mexico. Licensed in New Mexico. Registered with an NPI since 2013.

Licensed in
NM
In the registry since
2013
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Practice location Address checks out

101 W Broadway Ste D
Farmington, NM 87401-6419
Phone: (505) 327-4796
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 0160331 (NM)

Record details

NPI number1972933844
Entity typeIndividual (Type 1)
GenderFemale
Credentials BSW , LSAA
Sole proprietorNo
NPI enumeratedNovember 13, 2013
Last updated in NPPESNovember 13, 2013

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