Russell Edward Spieth, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

P.07811 Issued in OH

Practice address

8040 Corporate Cir
North Royalton, OH 44133-1282

Phone

(216) 320-9621

NPI assigned

Feb 16, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1581811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1760015978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 CORPORATE CIR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331282",
            "telephone_number": "216-320-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8040 CORPORATE CIR",
            "city": "NORTH ROYALTON",
            "state": "OH",
            "postal_code": "441331282",
            "telephone_number": "216-320-9621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2322 E 22nd St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441153100",
            "country_code": "US",
            "telephone_number": "216-363-2570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIETH",
        "first_name": "RUSSELL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-16",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "OH",
            "license": "P.07811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "directmob200@cleveland.ipsmso.com",
            "affiliation": "Y",
            "affiliationName": "Outreach Professional Services Inc",
            "address_1": "2322 E 22nd St Ste 200",
            "city": "Cleveland",
            "state": "OH",
            "country_code": "US",
            "postal_code": "441153100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Counseling Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.