Wendy Russell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH11747 Issued in FL

Practice address

405 Commercial CT Ste E
Venice, FL 34292-1653

Phone

(941) 375-4321

NPI assigned

Apr 27, 2016

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)

Not enrolled

State licenses

Practice roles

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.

• Eagle'S Wings Counseling Center, Inc.

  • Mental Health Counselor
  • Venice, FL
  • NPI 1174857486
  NPD (past)

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1013362060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8461 EAGLE PRESERVE WAY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342419449",
            "telephone_number": "941-356-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 COMMERCIAL CT STE E",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342921653",
            "telephone_number": "941-375-4321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WENDY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH11747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Rubin, OD
• Jillian Rubin
• Shellie G Rubin
• James R. Rubinsak, M.D.
• Jacquelynn Ann Rubsam, CNP
• Francis Alberto Russo
• Oliva Russo, APRN
• Shelly Russo, APRN
• Kimberly Ann Ruzek, MD
• Ryan S. Holbrook, DMD, P.a.

• Mental Health Counselor in Venice, FL
• Providers in Venice, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; 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.