Active NPI
Russell William Schulte, LPC
- Professional Counselor
- Pearl, MS
National Provider Identifier
1336299288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1207
- Practice address
- 5611 Highway 80 E
Pearl, MS 39208-8929 - Phone
- (601) 939-6634
- Fax
- (601) 420-9252
- NPI assigned
- Jan 11, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1207 | MS | Primary |
Addresses
Primary practice location
5611 Highway 80 E
Pearl, MS 39208-8929
Mailing address
5417 Wayneland Dr
Jackson, MS 39211-4044
Phone (601) 842-4385
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1207 | MS | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watershed Counseling Associates, PLLC | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Jackson, MS
- NPI 1407284235
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336299288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5417 WAYNELAND DR",
"city": "JACKSON",
"state": "MS",
"postal_code": "392114044",
"telephone_number": "601-842-4385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5611 HIGHWAY 80 E",
"city": "PEARL",
"state": "MS",
"postal_code": "392088929",
"telephone_number": "601-939-6634",
"fax_number": "601-420-9252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHULTE",
"first_name": "RUSSELL",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MS",
"license": "1207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl, MS
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.