NPIMap

Organization Active NPI

Russell Wellness and Recovery Center LLC

  • Rehabilitation Psychologist
  • Elkton, MD
National Provider Identifier
1275477333
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Legal business name
RUSSELL WELLNESS AND RECOVERY CENTER LLC
Practice address
109 N Bridge St
Elkton, MD 21921-5326
Phone
(667) 441-4677
NPI assigned
Apr 17, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Authorized official

Name
Kathleen Phipps
Title
Office Manager
Phone
(661) 313-3184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TR0400X Primary

Addresses

Primary practice location

109 N Bridge St
Elkton, MD 21921-5326

Mailing address

109 N Bridge St
Elkton, MD 21921-5326

National Provider Directory

National Provider Directory
Tax ID family
Russell Wellness and Recovery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1776384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776384000000",
    "number": "1275477333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N BRIDGE ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N BRIDGE ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215326",
            "telephone_number": "667-441-4677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSELL WELLNESS AND RECOVERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-17",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "661-313-3184"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.