Individual provider Active NPI

Joelle Russum

  • Marriage & Family Therapist
  • Los Angeles, CA
National Provider Identifier
1548969397
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
154203 Issued in CA
Practice address
515 Columbia Ave # 200
Los Angeles, CA 90017-1209
Phone
(213) 249-9388
Fax
(213) 389-7993
NPI assigned
Mar 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 138304 CA
Marriage & Family Therapist 106H00000X 138304 CA
Marriage & Family Therapist 106H00000X 154203 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

515 Columbia Ave # 200
Los Angeles, CA 90017-1209

Mailing address

515 Columbia Ave # 200
Los Angeles, CA 90017-1209
Phone (213) 249-9388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250710003697 CA Practitioner - Marriage and Family Therapist 6204340193 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
138304CAMDMental Health Counselor
154203CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Service for Groups, Inc. Current Accepting new patients
Special Service for Groups, Inc. CurrentSince Mar 25, 2025 Accepting new patients
Special Service for Groups, Inc. CurrentSince Mar 25, 2025 Accepting new patients
Jeanne Young, PHD, a Psychological Corporation PastSince Oct 27, 2024 Accepting new patients

Locations

905 E 8th St
Los Angeles, CA 90021
Phone (213) 553-1800

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1677628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747785600000",
    "number": "1548969397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 COLUMBIA AVE # 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171209",
            "telephone_number": "213-249-9388",
            "fax_number": "213-389-7993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 COLUMBIA AVE # 200",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900171209",
            "telephone_number": "213-249-9388",
            "fax_number": "213-389-7993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSUM",
        "first_name": "JOELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-01",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "138304",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138304",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "154203",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.