Ellie Claire Russell, IMT4219

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMT4219 Issued in FL

Practice address

715 N Washington Blvd
Sarasota, FL 34236-4256

Phone

(941) 876-8990

NPI assigned

Jan 13, 2025

Last updated

Jan 13, 2025By 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 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": "1736726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1427868181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 110TH AVE N APT 510",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337163153",
            "telephone_number": "615-878-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N WASHINGTON BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342364256",
            "telephone_number": "941-876-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ELLIE",
        "middle_name": "CLAIRE",
        "credential": "IMT4219",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-13",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "IMT4219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecille M Ruiz, DMD
• Robert D Runk, PA
• Kyle K. Runnels, M.D.
• Lauren H Runnels, MD
• Charles W Rush, MD
• Kristina D Russell, D.M.D.
• Lisa Russell, LM
• Nicole Russini, MD
• Holly Lynn Russo, C.R.N.A.
• John Russo, DDS

• Marriage & Family Therapist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; 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.