Individual provider Active NPI

Juan Miguel Russian

  • Mental Health Counselor
  • Flower Mound, TX
National Provider Identifier
1588528186
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
91083 Issued in TX
Practice address
3204 Long Prairie Rd Ste a
Flower Mound, TX 75022-4958
Phone
(903) 780-6097
NPI assigned
Dec 10, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 91083 TX Primary

Addresses

Primary practice location

3204 Long Prairie Rd Ste a
Flower Mound, TX 75022-4958

Mailing address

1870 Rufe Snow Dr
Keller, TX 76248-5629
Phone (903) 780-6097

Other practice location 1

1870 Rufe Snow Dr
Keller, TX 76248-5629
Phone (903) 780-6097

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

LicenseStateTypeSpecialty
91083TXMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1588528186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1870 RUFE SNOW DR",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485629",
            "telephone_number": "903-780-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 LONG PRAIRIE RD STE A",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750224958",
            "telephone_number": "903-780-6097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1870 Rufe Snow Dr",
            "address_purpose": "LOCATION",
            "city": "Keller",
            "state": "TX",
            "postal_code": "762485629",
            "country_code": "US",
            "telephone_number": "903-780-6097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSIAN",
        "first_name": "JUAN MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-10",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "91083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.