Active NPI
Laurie Russell, PSYD
- Clinical Psychologist
- San Antonio, TX
National Provider Identifier
1083287809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 38677
- Practice address
- 9939 Highway 151
San Antonio, TX 78251-1900 - Phone
- (210) 706-7800
- NPI assigned
- Jul 20, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 38677 | TX | Primary |
Addresses
Primary practice location
9939 Highway 151
San Antonio, TX 78251-1900
Mailing address
9939 Highway 151
San Antonio, TX 78251-1900
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 |
|---|---|---|---|
| 38677 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1083287809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9939 HIGHWAY 151",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782511900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9939 HIGHWAY 151",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782511900",
"telephone_number": "210-706-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "LAURIE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-20",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "38677",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.