Shannon L Russell

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

14 Fordham Rd
Allston, MA 02134-3006

Phone

(617) 782-6460

NPI assigned

Sep 17, 2013

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Wellness Journey Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Marlborough, MA
  • NPI 1083457634
  NPD Authorized official
• Rollins Counseling Center LLC

  • Clinical Social Worker
  • Westford, MA
  • NPI 1083220206
  NPD

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1720414238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 FORDHAM RD",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343006",
            "telephone_number": "617-782-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 FORDHAM RD",
            "city": "ALLSTON",
            "state": "MA",
            "postal_code": "021343006",
            "telephone_number": "617-782-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHANNON",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Rachel Ross
• Royal Rehab Center, Inc
• Jacey Ruisi
• Jane Ellen Rupp
• Samantha Brooke Russell
• Samantha Rynderman
• Matthew A Sablan
• Jose Alberto Saez
• Georgina Sakellariadis
• Ana Patricia Sanchez

• Counselor in Allston, MA
• Providers in Allston, MA by specialty
• Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.