Michele R. Russell, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2131 Issued in GA

Practice address

1708 Peachtree St NW
Suite 505
Atlanta, GA 30309-2434

Phone

(404) 872-8065

Fax

(404) 872-0925

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

Yes

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

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.

Opted out of Medicare

Yes, effective Oct 25, 2016 through Oct 25, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Phoenix and Pearl Counseling Services, LLC

  • Marriage & Family Therapist
  • Atlanta, GA
  • NPI 1316243975
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255422580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 PEACHTREE ST NW",
            "address_2": "SUITE 505",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092434",
            "telephone_number": "404-872-8065",
            "fax_number": "404-872-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 PEACHTREE ST NW",
            "address_2": "SUITE 505",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303092434",
            "telephone_number": "404-872-8065",
            "fax_number": "404-872-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MICHELE",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "2131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Louise Russell, DO
• Keisha A Russell, OTR L
• Kim L Russell, PAC
• Lorraine Elizabeth Russell, LMT
• Maria Citarella Russell, M.D.
• Scott M Russell, MS CCC-SLP
• Stephen Russell, MD
• Trey Russell, D.C.
• Tyren Russell
• Andrea Russo, MS, LAPC

• Psychologist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.