Active NPI
Russell F Lee, E.D., LP
- Counseling Psychologist
- Bemidji, MN
National Provider Identifier
1023263456
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP1813
- Practice address
- 722 15TH St NW
Bemidji, MN 56601-2528 - Phone
- (218) 751-3280
- Fax
- (218) 751-3298
- NPI assigned
- Nov 26, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP1813 | MN | Primary |
Addresses
Primary practice location
722 15TH St NW
Bemidji, MN 56601-2528
Mailing address
722 15TH St NW
Bemidji, MN 56601-2528
Phone (218) 751-3280
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1813 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227657600000",
"number": "1023263456",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "722 15TH ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566012528",
"telephone_number": "218-751-3280",
"fax_number": "218-751-3298"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "722 15TH ST NW",
"city": "BEMIDJI",
"state": "MN",
"postal_code": "566012528",
"telephone_number": "218-751-3280",
"fax_number": "218-751-3298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "RUSSELL",
"middle_name": "F",
"credential": "E.D., LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-26",
"last_updated": "2008-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP1813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bemidji, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.