Individual provider Active NPI

Lori Russ-Eisenschenk, PH.D.

  • Counseling Psychologist
  • Gainesville, FL
National Provider Identifier
1659524361
Registry record updated Aug 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY5935 Issued in FL
Practice address
2653 SW 87TH Dr
Suite a
Gainesville, FL 32608-9313
Phone
(352) 331-0020
Fax
(352) 331-0022
NPI assigned
Oct 24, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PY5935 FL Primary

Addresses

Primary practice location

2653 SW 87TH Dr
Suite a
Gainesville, FL 32608-9313

Mailing address

2653 SW 87TH Dr
Suite a
Gainesville, FL 32608-9313
Phone (352) 331-0020

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY5935FLMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249948800000",
    "number": "1659524361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2653 SW 87TH DR",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089313",
            "telephone_number": "352-331-0020",
            "fax_number": "352-331-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 SW 87TH DR",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326089313",
            "telephone_number": "352-331-0020",
            "fax_number": "352-331-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS-EISENSCHENK",
        "first_name": "LORI",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-24",
        "last_updated": "2009-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY5935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; 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.