Active NPI
Karli Brooke Russell, LPC
- Counselor
- Waycross, GA
National Provider Identifier
1548719016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 8193
- Practice address
- 204 S Crawford St
Waycross, GA 31503-2612 - Phone
- (912) 282-0992
- Fax
- (912) 285-8817
- NPI assigned
- Sep 26, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 8193 | GA | Primary |
Addresses
Primary practice location
204 S Crawford St
Waycross, GA 31503-2612
Mailing address
204 S Crawford St
Waycross, GA 31503-2612
Phone (912) 282-0992
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 |
|---|---|---|---|
| 8193 | GA | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1548719016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "204 S CRAWFORD ST",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315032612",
"telephone_number": "912-282-0992",
"fax_number": "912-285-8817"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "204 S CRAWFORD ST",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315032612",
"telephone_number": "912-282-0992",
"fax_number": "912-285-8817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KARLI",
"middle_name": "BROOKE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-26",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "GA",
"license": "8193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waycross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.