Shinah Russell, ED.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC010919 Issued in GA

Practice address

7084 Roselake Cir
Douglasville, GA 30134-1680

Phone

(850) 570-1894

NPI assigned

Sep 23, 2019

Last updated

Sep 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: shinahquinnrussell@tdh.allscriptsdirect.net

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.

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  Professional

  NPD

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

{
    "created_epoch": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569196800000",
    "number": "1700437514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7084 ROSELAKE CIR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341680",
            "telephone_number": "850-570-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7084 ROSELAKE CIR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341680",
            "telephone_number": "850-570-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHINAH",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2019-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rsa Psychological Services (New Foundations)
• RSVP Assured Trans, LLC.
• Whitney M Rudd
• Navinchandra M Ruparelia, MD
• Rachel Marie Russell
• Rosemarie Russo, DC
• Josette Rutland-Burrus
• Bethany Lowe Ryan
• Hanif Sa Shekhem
• Carolynn Saba

• Professional Counselor in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2019; 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.