William Russell, PCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.1100210 Issued in OH

Practice address

3920 Lovers LN
Ravenna, OH 44266-4200

Phone

(330) 673-1347

Fax

(330) 678-3677

NPI assigned

Jul 26, 2014

Sex

Male

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

Enrolled in OH

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Coleman Professional Services, Inc.

  • Mental Health Counselor
  • Kent, OH
  • NPI 1982637633

  Professional

  Medicare reassignment NPD
• Community Support Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Akron, OH
  • NPI 1053309294
  NPD (past)

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

{
    "created_epoch": "1406332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406332800000",
    "number": "1740698331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5982 RHODES RD",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442404128",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 LOVERS LN",
            "city": "RAVENNA",
            "state": "OH",
            "postal_code": "442664200",
            "telephone_number": "330-673-1347",
            "fax_number": "330-678-3677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "WILLIAM",
        "credential": "PCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-26",
        "last_updated": "2014-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.1100210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis James Rude, PHARM.D.
• Sarah Abigail Rumsey
• Brenda Rose Russell, LPN
• Lauren Russell
• Rachel Russell, OTR/L
• Briana Michelle Ryan
• Stephanie Ryan, PHARM D.
• Amy L Ryser, OT
• S & S Pharmacy Inc
• Saber

• Professional Counselor in Ravenna, OH
• Providers in Ravenna, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2014; 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.