Julie Russell, PMHCNS-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

0015000440 Issued in VA

Practice address

5597 Cedar Break Dr
Centreville, VA 20120-3329

Phone

(703) 830-6315

NPI assigned

Dec 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1003145152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "443 CARLISLE DR STE A",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201705623",
            "telephone_number": "703-581-5875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5597 CEDAR BREAK DR",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201203329",
            "telephone_number": "703-830-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JULIE",
        "name_prefix": "Ms.",
        "credential": "PMHCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "VA",
            "license": "0015000440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Centreville, VA
• Providers in Centreville, VA by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.