Gary Lee Russell, LPCC-S, LICDC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

E.2001844-SUPV Issued in OH

Practice address

151 Marion Ave
Mansfield, OH 44903-2223

Phone

(419) 774-9969

NPI assigned

Aug 1, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• OH PPO
• KY PPO C-SNP
• devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
• KY PPO
• devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
• devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
• devoted network organization-2d523d8e-e8f9-454a-bcd3-333df65bdbe8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Be Better Counseling, LLC

  • Mental Health Counselor
  • Ontario, OH
  • NPI 1760247001

  Addiction (Substance Use Disorder)

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1003394180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 S LEXINGTON SPRINGMILL RD",
            "city": "ONTARIO",
            "state": "OH",
            "postal_code": "449061325",
            "telephone_number": "419-528-8008",
            "fax_number": "877-486-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MARION AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449032223",
            "telephone_number": "419-774-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GARY",
        "middle_name": "LEE",
        "credential": "LPCC-S, LICDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.162577",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2001844-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Runyon'S
• Candace L. Rush
• Jessica Rush, LPC
• Judith Rush, TO
• Emily Danielle Hoffman Russell, MSW/LISW
• Madeline C Russell, LPTA
• Robyn Russell
• Sharon Marie Russell, OTR/L
• Thomas A. Russell, M.A., M.ED., LPCC
• Stanley Rust

• Mental Health Counselor in Mansfield, OH
• Providers in Mansfield, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.