Laura Renay Russell, CMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

10322316-6004 Issued in UT

Practice address

5414 Daybreak Pkwy
C-4 #123
South Jordan, UT 84009

Phone

(385) 355-0830

Fax

(385) 308-7477

NPI assigned

Feb 11, 2020

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

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.

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1396377917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5414 DAYBREAK PKWY",
            "address_2": "C-4 #123",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84009",
            "telephone_number": "385-355-0830",
            "fax_number": "385-308-7477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 DAYBREAK PKWY",
            "address_2": "C-4 #123",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84009",
            "telephone_number": "385-355-0830",
            "fax_number": "385-308-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LAURA",
        "middle_name": "RENAY",
        "name_prefix": "Mrs.",
        "credential": "CMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-11",
        "last_updated": "2023-08-14",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "UT",
            "license": "10322316-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsi McCoard Roundy, M.D.
• Kaelin C Roy, AU.D.
• Jenna Renee Royall
• Kaylee Del Rudd, MFT
• Steven Eric Rush
• Bergen D Russon
• Ryan J. Mortensen, Inc (District Vision Care)
• Rainey Rymer
• Mindy Meyers Saari, LCSW
• Samantha Sadlier, CSW

• Mental Health Counselor in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Mental Health Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.