David Michael Russell, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1039 Issued in CT

Practice address

1001 Farmington Ave
Suite 304
West Hartford, CT 06107-2135

Phone

(860) 561-4841

Fax

(860) 561-4891

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• MCH/Russell Associates,LLC

  • Mental Health Counselor
  • West Hartford, CT
  • NPI 1023281292
  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1801006010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 FARMINGTON AVE",
            "address_2": "SUITE 304",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072135",
            "telephone_number": "860-561-4841",
            "fax_number": "860-561-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 FARMINGTON AVE",
            "address_2": "SUITE 304",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072135",
            "telephone_number": "860-561-4841",
            "fax_number": "860-561-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "1039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey H Rubin, APRN
• Karen Lee Rubinow, D.C., FIACA
• Ruby Psychiatric Services, PLLC
• Mary G Ruddat, MD
• Donald S Ruffett, MD
• Mark L Russell, APRN
• Gary Edward Russolillo, M.D.
• Michelle Rae Rusted
• Ruth L. Jacobson, Ms, LMFT, LLC
• Stanley J Rutstein, DPM

• Clinical Psychologist in West Hartford, CT
• Providers in West Hartford, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.