Thomas Russell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

672 Issued in GA

Practice address

8800 Roswell Rd Ste A135
Sandy Springs, GA 30350-1826

Phone

(404) 682-1923

NPI assigned

Sep 8, 2017

Last updated

Sep 8, 2017By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Twilynn Jourdain Enterprises, LLC

  dba Thriveworks Decatur Counseling & Life Coaching

  • Professional Counselor
  • Decatur, GA
  • NPI 1417415316
  NPD (past)

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504828800000",
    "number": "1205354396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JEFFERSON ST STE 2C",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245041724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 ROSWELL RD STE A135",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303501826",
            "telephone_number": "404-682-1923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2017-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "672",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debashish Roy, PHARMACIST
• Leah Elizabeth Roye, FNP STUDENT
• Alan N Rucket, M.D.
• Yareni Ruiz Perez
• Russell a Friedman PC
• Taisha Ryan
• S. Ikpe MD, LLC
• Elizabeth Safstrom
• Sagacity Surgical Group LLC (Sagacity Surgical Group)
• Sage Speech & Learning Associates, LLC

• Professional Counselor in Sandy Springs, GA
• Providers in Sandy Springs, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.