Laura J Russell, LLPC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

008111 Issued in GA

Practice address

29 Millard Farmer Ind Blvd
Suite B1
Newnan, GA 30263-5821

Phone

(678) 435-9949

NPI assigned

Dec 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Laura J Mackenzie Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• The Wellness Counselors, LLC

  • Counselor
  • Newnan, GA
  • NPI 1336511229
  NPD Authorized official

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

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481500800000",
    "number": "1679818074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73972",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302713972",
            "telephone_number": "678-435-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 MILLARD FARMER IND BLVD",
            "address_2": "SUITE B1",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302635821",
            "telephone_number": "678-435-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LAURA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-11",
        "last_updated": "2016-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401012348",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "GA",
            "license": "008111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "MACKENZIE",
            "middle_name": "J",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Samuel Rudolph, D.O.
• Vanessa Danyelle Elizabeth Ruiz
• Yoshio Walter Ruiz, MSW
• Ruki & LT LLC
• Yvonne Marie Russ, LPC, CMAC
• Mary Katherine Ryan, NP
• S&S Helping Hands LLC
• S&T Assessment and Counseling Service, Inc.
• Sara Saavedra, APRN-FNP
• Sacred Journey Hospice, LLC

• Counselor in Newnan, GA
• Providers in Newnan, GA by specialty
• Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.