Individual provider Active NPI

Andrea A. Russell, PH.D.

  • EEG Technician
  • Tucson, AZ
National Provider Identifier
1013059526
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EEG TechnicianTaxonomy code 2472E0500X
License
AZ LPC 1342 Issued in AZ
Practice address
7660 E Broadway Blvd
Suite 207
Tucson, AZ 85710-3774
Phone
(520) 885-0557
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X AZ LPC 1342 AZ
Cognitive & Behavioral Psychologist 103TB0200X AZ LPC 1342 AZ
Clinical Psychologist 103TC0700X AZ LPC 1342 AZ
Counseling Psychologist 103TC1900X AZ LPC 1342 AZ
Clinical Child & Adolescent Psychologist 103TC2200X AZ LPC 1342 AZ
Family Psychologist 103TF0000X AZ LPC 1342 AZ
Intellectual & Developmental Disabilities Psychologist 103TM1800X AZ LPC 1342 AZ
Psychologist 103T00000X AZ LPC 1342 AZ
Group Psychotherapy Psychologist 103TP2701X AZ LPC 1342 AZ
EEG Specialist/Technologist 246ZE0500X AZ LPC 1342 AZ
EEG Technician 2472E0500X AZ LPC 1342 AZ Primary

Addresses

Primary practice location

7660 E Broadway Blvd
Suite 207
Tucson, AZ 85710-3774

Mailing address

7660 E Broadway Blvd
Suite 207
Tucson, AZ 85710-3774
Phone (520) 885-0557

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
AZ LPC 1342AZMDEEG Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Christian Counseling Psychologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1013059526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7660 E BROADWAY BLVD",
            "address_2": "SUITE 207",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103774",
            "telephone_number": "520-885-0557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7660 E BROADWAY BLVD",
            "address_2": "SUITE 207",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857103774",
            "telephone_number": "520-885-0557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": false
        },
        {
            "code": "2472E0500X",
            "taxonomy_group": "",
            "desc": "Technician, Other, EEG",
            "state": "AZ",
            "license": "AZ LPC 1342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.