Active NPI
Scott I Russell, MSW
- Mental Health Counselor
- Los Angeles, CA
National Provider Identifier
1740732338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- ASW71593
- Practice address
- 1224 Vine St
Los Angeles, CA 90038-1612 - Phone
- (323) 769-6100
- NPI assigned
- Oct 29, 2016
- Sex
- Male
- Sole proprietor
- No
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 | ASW71593 | CA | Primary |
Addresses
Primary practice location
1224 Vine St
Los Angeles, CA 90038-1612
Mailing address
1224 Vine St
Los Angeles, CA 90038-1612
Phone (323) 769-6100
Other practice location 1
720 Wood St.
Eureka, CA 95501
Phone (707) 268-2990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ASW71593 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563667200000",
"number": "1740732338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1224 VINE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900381612",
"telephone_number": "323-769-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 VINE ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900381612",
"telephone_number": "323-769-6100"
}
],
"practiceLocations": [
{
"address_1": "720 Wood St.",
"address_purpose": "LOCATION",
"city": "Eureka",
"state": "CA",
"postal_code": "95501",
"country_code": "US",
"telephone_number": "707-268-2990",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "SCOTT",
"middle_name": "I",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-29",
"last_updated": "2019-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ASW71593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.