Active NPI
Ernestine Michelle Russ-Williams, LAC, CRC
- Professional Counselor
- North Little Rock, AR
National Provider Identifier
1790084739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A1101012
- Practice address
- 1005 W B Ave
North Little Rock, AR 72116-9180 - Phone
- (501) 249-4056
- NPI assigned
- Mar 16, 2011
- Sex
- Female
- 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 | A1101012 | AR | Primary |
Addresses
Primary practice location
1005 W B Ave
North Little Rock, AR 72116-9180
Mailing address
1005 W B Ave
North Little Rock, AR 72116-9180
Phone (501) 249-4056
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 |
|---|---|---|---|
| A1101012 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300233600000",
"number": "1790084739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 W B AVE",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721169180",
"telephone_number": "501-249-4056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 W B AVE",
"city": "NORTH LITTLE ROCK",
"state": "AR",
"postal_code": "721169180",
"telephone_number": "501-249-4056"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSS-WILLIAMS",
"first_name": "ERNESTINE",
"middle_name": "MICHELLE",
"credential": "LAC, CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-16",
"last_updated": "2011-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "A1101012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.