Provider Demographics
NPI:1053441725
Name:PHILPOTT, RUSSELL DEAN (M ED, LPC)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:DEAN
Last Name:PHILPOTT
Suffix:
Gender:M
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 COLLEGE PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26104-7616
Mailing Address - Country:US
Mailing Address - Phone:304-485-3345
Mailing Address - Fax:304-485-3345
Practice Address - Street 1:225 COLLEGE PKWY STE 101
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26104-7616
Practice Address - Country:US
Practice Address - Phone:304-485-3345
Practice Address - Fax:304-485-3345
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1598101Y00000X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1598OtherWV LPC NUMBER