Individual provider Active NPI

Brittany Russell

  • Mental Health Counselor
  • West Seneca, NY
National Provider Identifier
1104312487
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010948-01 Issued in NY
Practice address
326 Orchard Park Rd
West Seneca, NY 14224-2635
Phone
(716) 662-6638
Fax
(716) 828-1522
NPI assigned
Jul 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Counselor 101Y00000X 010948-01 NY
Mental Health Counselor 101YM0800X 010948-01 NY Primary

Addresses

Primary practice location

326 Orchard Park Rd
West Seneca, NY 14224-2635

Mailing address

227 Thorn Ave
Orchard Park, NY 14127-2600
Phone (716) 662-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20240125000390 NY Practitioner - Mental Health Counselor 8123471232 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Erie County South East Corp VGroup PAC ID 9638079023, 22 clinicians

Practice addresses (Care Compare)

326 Orchard Park Rd
West Seneca, NY 14224-2635
Phone (716) 662-6638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010948-01NYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Erie County South East Corp V CurrentSince Jan 1, 2024 Accepting new patients

Locations

2040 Seneca St
Buffalo, NY 14210
Phone (716) 828-0560

227 Thorn Ave
Orchard Park, NY 14127
Phone (716) 539-6737

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": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1104312487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 THORN AVE",
            "city": "ORCHARD PARK",
            "state": "NY",
            "postal_code": "141272600",
            "telephone_number": "716-662-2040",
            "fax_number": "716-662-0019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 ORCHARD PARK RD",
            "city": "WEST SENECA",
            "state": "NY",
            "postal_code": "142242635",
            "telephone_number": "716-662-6638",
            "fax_number": "716-828-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "010948-01",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010948-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Seneca, NY

Sources for this page

Verify at the official NPI Registry.