Active NPI
Sharon Alene Russell
- Mental Health Counselor
- Henderson, NV
National Provider Identifier
1649574096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CP0161
- Practice address
- 871 Coronado Center Dr Ste 200
Henderson, NV 89052-3977 - Phone
- (702) 940-2371
- Fax
- (702) 940-2372
- NPI assigned
- Dec 28, 2010
- Last updated
- Jul 21, 2022
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CP0161 | NV | Primary |
Addresses
Primary practice location
871 Coronado Center Dr Ste 200
Henderson, NV 89052-3977
Mailing address
871 Coronado Center Dr
Ste 200
Henderson, NV 89052-3977
Phone (702) 940-2371
Other practice location 1
2110 E Flamingo Rd Ste 315
Las Vegas, NV 89119-5193
Phone (702) 272-0987
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649574096 | Medicaid | NV |
Other names 1
- Ms. Sharon Alene Booth
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 |
|---|---|---|---|
| CP0161 | NV | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascendant Counseling Center Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Henderson, NV
- NPI 1154942860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1649574096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "871 CORONADO CENTER DR",
"address_2": "STE 200",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523977",
"telephone_number": "702-940-2371",
"fax_number": "702-940-2372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "871 CORONADO CENTER DR STE 200",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890523977",
"telephone_number": "702-940-2371",
"fax_number": "702-940-2372"
}
],
"practiceLocations": [
{
"address_1": "2110 E Flamingo Rd Ste 315",
"address_purpose": "LOCATION",
"city": "Las Vegas",
"state": "NV",
"postal_code": "891195193",
"country_code": "US",
"telephone_number": "702-272-0987",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "SHARON",
"middle_name": "ALENE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-28",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CP0161",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1649574096",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHARON",
"last_name": "BOOTH",
"middle_name": "ALENE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.