MRS. TISA BERNALLY-RUSSELL BSW, LSAA
NPI 1972933844
Counselor - Addiction (Substance Use Disorder) in Farmington, NM

Q: What is Tisa Bernally-russell's NPI number?

The NPI number for Tisa Bernally-russell is 1972933844. It was assigned to this individual provider in the NPPES registry on November 13, 2013.

Q: What is Tisa Bernally-russell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Active since November 13, 2013

101 W BROADWAY, SUITE D, FARMINGTON, NM 87401(505) 327-4796 Get Directions Write a Review

NPPES record last updated: November 13, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mrs. Tisa Bernally-russell Bsw, Lsaa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. TISA BERNALLY-RUSSELL BSW, LSAA (NPI 1972933844) is an individual addiction (substance use disorder) provider in Farmington, New Mexico, licensed in New Mexico (0160331) and active in the NPI registry since November 2013.

NPPES Registry Identity

NPI1972933844

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMRS. TISA BERNALLY-RUSSELLCredential: BSW, LSAA

Location Address101 W BROADWAY, SUITE DFarmington, NM 87401-6419

Mailing AddressPo Box 3239, 101 W. Broadway, Suite DFarmington, NM 87499-3239 · (505) 327-4796

Phone(505) 327-4796

Sole ProprietorNo

Enumeration DateNovember 13, 2013

✔ NPI 1972933844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in NM · 0160331

101 W BROADWAY, Farmington, NM 87401

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER A JACQUEZ

Behavior Analyst

101 W BROADWAY
FARMINGTON, NM 87401

San Juan County (505) 327-4796

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tisa Bernally-russell's NPI number?

The NPI number for Tisa Bernally-russell is 1972933844. It was assigned to this individual provider in the NPPES registry on November 13, 2013.

Where is Tisa Bernally-russell located?

Tisa Bernally-russell practices at 101 W Broadway Suite D, Farmington, NM 87401. The listed phone number is (505) 327-4796.

What is Tisa Bernally-russell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Tisa Bernally-russell was last updated on November 13, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.