Stephanie Michelle Russell

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

009894 Issued in NY

Practice address

1211 Stewart Ave Ste 100
Bethpage, NY 11714-1601

Phone

(399) 851-6465

NPI assigned

Jul 17, 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: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• University of North Carolina at Chapel Hill

  • Neurological Surgery Physician
  • South Boston, VA
  • NPI 1407308703
  NPD
• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200
  NPD
• University of North Carolina at Chapel Hill

  • Primary Care Clinic/Center
  • Chapel Hill, NC
  • NPI 1184882045
  NPD (past)

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

{
    "created_epoch": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1568070316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 5TH AVE # 3F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112158136",
            "telephone_number": "303-505-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 STEWART AVE STE 100",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117141601",
            "telephone_number": "399-851-6465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "367 5th Ave # 3F",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112158136",
            "country_code": "US",
            "telephone_number": "303-505-1790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "STEPHANIE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "009894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert F Rothman, M.D.
• Renitha Roy, DO
• Alberta Rubin, LCSW-R
• Laurence Rubin, MD
• Brent Russell, LMSW
• Leah Gillgannon Russo, M.A., CCC-SLP
• Cody T Ryan
• Melissa Ryan
• Tina Lynn Ryan, L.M.T
• Jennifer Leigh Sachs, LCSW

• Mental Health Counselor in Bethpage, NY
• Providers in Bethpage, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.