Active NPI
Dane Russell, LPC
- Professional Counselor
- Aurora, CO
National Provider Identifier
1760777569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1995
- Practice address
- 3222 S Jebel Way
Aurora, CO 80013-9014 - Phone
- (303) 909-5692
- NPI assigned
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1995 | CO | Primary |
Addresses
Primary practice location
3222 S Jebel Way
Aurora, CO 80013-9014
Mailing address
68 S Moline St
Aurora, CO 80012-1274
Phone (303) 909-5692
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 |
|---|---|---|---|
| 1995 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307577600000",
"number": "1760777569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "68 S MOLINE ST",
"city": "AURORA",
"state": "CO",
"postal_code": "800121274",
"telephone_number": "303-909-5692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3222 S JEBEL WAY",
"city": "AURORA",
"state": "CO",
"postal_code": "800139014",
"telephone_number": "303-909-5692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "DANE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-09",
"last_updated": "2011-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "1995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.