Active NPI
Russell Keith Ammons
- Mental Health Counselor
- Lewisville, TX
National Provider Identifier
1689584104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 103856
- Practice address
- 290 W Lake Park Rd Apt 1104
Lewisville, TX 75057-3889 - Phone
- (469) 975-6550
- NPI assigned
- Sep 8, 2026
- Sex
- Male
- Sole proprietor
- Yes
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 | 103856 | TX | Primary |
Addresses
Primary practice location
290 W Lake Park Rd Apt 1104
Lewisville, TX 75057-3889
Mailing address
290 W Lake Park Rd Apt 1104
Lewisville, TX 75057-3889
Phone (469) 975-6550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1689584104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 W LAKE PARK RD APT 1104",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573889",
"telephone_number": "469-975-6550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 W LAKE PARK RD APT 1104",
"city": "LEWISVILLE",
"state": "TX",
"postal_code": "750573889",
"telephone_number": "469-975-6550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMMONS",
"first_name": "RUSSELL",
"middle_name": "KEITH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2026-09-08",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "103856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lewisville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.