Rebecca Amber Crowe Russell, M.S. , CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7173 Issued in NC

Practice address

13721 Heritage Dr
Laurinburg, NC 28352-9185

Phone

(910) 206-8228

NPI assigned

Jun 4, 2008

Last updated

Dec 13, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life 360 Therapy Services, Inc

  • Speech-Language Pathologist
  • Laurinburg, NC
  • NPI 1508238403
  NPD Authorized official

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1285893354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13721 HERITAGE DRIVE",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "28352",
            "telephone_number": "910-206-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13721 HERITAGE DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283529185",
            "telephone_number": "910-206-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "REBECCA",
        "middle_name": "AMBER CROWE",
        "credential": "M.S. , CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-04",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7173",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "4110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frank Ernest Roofe III, O.D.
• Stephanie Rousseau, LAT, ATC
• Jonathan David Rowson, MD
• Paul Fletcher Rush, MD
• Lee Ann Russell, CRNA
• Ryan, James, Wiles, Patel & Olsen LLP (Village Family Dental)
• Montell D Salary, M.D.
• Leslie John Salloum, MD
• Kenneth Earl Samuda
• Teresa Samuel, LCSW

• Speech-Language Pathologist in Laurinburg, NC
• Providers in Laurinburg, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.