R Russ, PH.D., SUDP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60373444 Issued in WA

Practice address

1548 River Rd Unit 105
Longview, WA 98632-3293

Phone

(520) 260-4584

NPI assigned

Dec 6, 2013

Last updated

May 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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 WA

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

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Life IncGroup PAC ID 8123433034, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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

• Total Life Inc.

  • Group Psychotherapy Psychologist
  • Jupiter, FL
  • NPI 1053909267

  WA

  Medicare reassignment Care Compare group NPD
• Total Life FL PA

  dba Total Life

  • Integrative Medicine Physician
  • Potomac, MD
  • NPI 1447057286

  WA

  Medicare reassignment NPD
• Resources United Supportive Service

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1336990423
  NPD (past) Authorized official
• Coram Deo Counseling, LLC

  • Adult Mental Health Clinic/Center
  • Shelton, WA
  • NPI 1598591497
  NPD (past)
• Core Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Longview, WA
  • NPI 1639693781
  NPD (past)
• Centrepointe Counseling, Inc.

  • Pastoral Counselor
  • Ashton, MD
  • NPI 1528014966
  NPD (past)
• Codac Behavioral Health Services of Pima County, Inc.

  • Adult Mental Health Clinic/Center
  • Tucson, AZ
  • NPI 1356374953
  NPD (past)

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1023449634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2394",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328455",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1548 RIVER RD UNIT 105",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323293",
            "telephone_number": "520-260-4584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "748 14th Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "WA",
            "postal_code": "986322315",
            "country_code": "US",
            "telephone_number": "360-200-5419",
            "fax_number": "360-200-6736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSS",
        "first_name": "R",
        "name_prefix": "Dr.",
        "credential": "PH.D., SUDP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-12-06",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00000957",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60373444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel M Roylance, PA
• Nicole Renee Rubash, OTR/L
• Daniel Huerta Ruiz, M.S., A.T.,C
• Sarah M Rundell, M.A.
• April Rupp, CPC
• Courtney G Russell, AAC, CPC
• Irina Rutkowski
• Kara Ruzicka, PHARMD
• Justin M Ryan, AAC, BS
• Kathy Ann Ryan

• Psychologist in Longview, WA
• Providers in Longview, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.