Amanda Leigh Russell, LPC-MHSP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3202 Issued in TN

Practice address

2180 Union Ave
Memphis, TN 38104-4205

Phone

(901) 276-2200

NPI assigned

Sep 23, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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)

Not enrolled

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 and National Provider Directory roles.

• Kindred Place, Inc.

  • Community/Behavioral Health Agency
  • Memphis, TN
  • NPI 1619241643
  NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600819200000",
    "number": "1235745316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4561 AMBOY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381176101",
            "telephone_number": "901-335-9782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044205",
            "telephone_number": "901-276-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "AMANDA",
        "middle_name": "LEIGH",
        "credential": "LPC-MHSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "3202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lewis Rushing
• Megan Leigh Rushing, DNP, CPNP-AC
• Reagan M Rushing
• Russell D. Beis MD PC (Integrated Medicine Clinic)
• Russell H. Patterson III, MD
• Danyell Russell
• Delvin Russell, PHARMD
• Haley Russell, APRN
• Jason Thomas Russell
• Jonbrighton Childs Russell, DMD

• Professional Counselor in Memphis, TN
• Providers in Memphis, TN by specialty
• Professional Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.