Individual provider Active NPI

Brandy R Russell, MS, LPCC

  • Professional Counselor
  • Dayton, OH
National Provider Identifier
1154644474
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0701142 Issued in OH
Practice address
10552 Success LN Ste G
Dayton, OH 45458-3653
Phone
(937) 204-3647
Fax
(937) 791-6686
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0701142 OH Primary

Addresses

Primary practice location

10552 Success LN Ste G
Dayton, OH 45458-3653

Mailing address

2707 Allister Cir
Miamisburg, OH 45342-5859
Phone (937) 204-3647

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240828003818 OH Practitioner - Mental Health Counselor 0446799951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians
J Kilby Enterprises IncGroup PAC ID 7214302223, 8 clinicians

Practice addresses (Care Compare)

20 S 3Rd St
Suite 210
Columbus, OH 43215-4206
Phone (866) 630-0966

955 Congress Park Dr
Centerville, OH 45459-4009
Phone (937) 741-8708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
E.0701142OHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Ever Counseling LLC Mental Health CurrentSince May 1, 2026 Accepting new patients
J. Kilby Enterprises, Inc. Mental Health CurrentSince Aug 1, 2024 Accepting new patients

Locations

10552 Success Ln
Ste G
Dayton, OH 45458

955 Congress Park Dr
Dayton, OH 45459
Phone (937) 741-8708

550 N Main St
Unit A
Springboro, OH 45066
Phone (937) 741-8708

Organizations & group practices 3

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": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1154644474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2707 ALLISTER CIR",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453425859",
            "telephone_number": "937-204-3647",
            "fax_number": "937-791-6686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10552 SUCCESS LN STE G",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454583653",
            "telephone_number": "937-204-3647",
            "fax_number": "937-791-6686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BRANDY",
        "middle_name": "R",
        "credential": "MS, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0701142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.