Individual provider Active NPI

Russell Lin Hogan, MS, LPC, CASAC

  • Professional Counselor
  • Meridian, MS
National Provider Identifier
1750569158
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2007002469 Issued in MO
Practice address
1415 College Dr
Meridian, MS 39307-5345
Phone
(601) 483-4821
Fax
(601) 485-8727
NPI assigned
Feb 7, 2008
Last updated
Mar 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2007002469 MO Primary

Addresses

Primary practice location

1415 College Dr
Meridian, MS 39307-5345

Mailing address

1415 College Dr
Meridian, MS 39307-5345
Phone (601) 483-4821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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

Enrollment IDStateProvider typePAC IDDetails
I20240501001052 MS Practitioner - Mental Health Counselor 7517307093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Region Ten State of MsGroup PAC ID 4284605353, 13 clinicians

Practice addresses (Care Compare)

1415 College Dr
Meridian, MS 39307-5345
Phone 6014834821125

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2007002469MOMDProfessional Counselor
1613MSMDKinesiotherapist

Practice roles

OrganizationSpecialtyStatusNew patients
Region Ten Commission State of Ms CurrentSince Mar 12, 2024 Accepting new patients

Locations

1415 College Dr
Meridian, MS 39307
Phone (601) 483-4821

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1750569158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821",
            "fax_number": "601-485-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLLEGE DR",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393075345",
            "telephone_number": "601-483-4821",
            "fax_number": "601-485-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "RUSSELL",
        "middle_name": "LIN",
        "name_prefix": "Mr.",
        "credential": "MS, LPC, CASAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2007002469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.