Mary Russell-Wright, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC 007138 Issued in GA

Practice address

104 Worthington CT
Tyrone, GA 30290-1550

Phone

(321) 279-7503

NPI assigned

Oct 17, 2014

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

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  GA

  Medicare reassignment Care Compare group NPD
• Serenity Community Services

  • Community/Behavioral Health Agency
  • NPI 1477889749
  NPD

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1588068670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WORTHINGTON CT",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901550",
            "telephone_number": "321-279-7503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 WORTHINGTON CT",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302901550",
            "telephone_number": "321-279-7503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL-WRIGHT",
        "first_name": "MARY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "GA",
            "license": "LPC 007138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jalonda Robinson, RBT
• Shawnee Romano
• Abigail C Ross
• Demia Rosser
• Nathalia Rowe
• Virgina Ponton Sack, MS
• Janoah Sallie
• Sapience Life Solutions LLC
• Sassy Hair
• Hannah Schrader

• Mental Health Counselor in Tyrone, GA
• Providers in Tyrone, GA by specialty
• Mental Health Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.