Penny Jo Russell, LCDCII

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

981062 Issued in OH

Practice address

116 E Main St
Belmont, OH 43718-9593

Phone

(740) 484-4141

Fax

(740) 484-4143

NPI assigned

Oct 31, 2017

Last updated

Mar 17, 2018By the provider in NPPES

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1509408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1326550393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MAIN ST",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439501040",
            "telephone_number": "740-484-4141",
            "fax_number": "740-484-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 E MAIN ST",
            "city": "BELMONT",
            "state": "OH",
            "postal_code": "437189593",
            "telephone_number": "740-484-4141",
            "fax_number": "740-484-4143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 W Main St",
            "address_purpose": "LOCATION",
            "city": "Saint Clairsville",
            "state": "OH",
            "postal_code": "439501040",
            "country_code": "US",
            "telephone_number": "740-484-4141",
            "fax_number": "740-484-4143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "PENNY",
        "middle_name": "JO",
        "credential": "LCDCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "981062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Belmont, OH
• Providers in Belmont, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.