Active NPI
William F. Russell, PH.D.
- Forensic Psychologist
- Philadelphia, PA
National Provider Identifier
1801943469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychologist
- License
- PS 006981 L
- Practice address
- 1241 Vine St
Suite 300
Philadelphia, PA 19107-1111 - Phone
- (215) 405-2100
- NPI assigned
- Jan 5, 2007
- 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 |
|---|---|---|---|---|
| Forensic Psychologist | 103TF0200X | PS 006981 L | PA | Primary |
Addresses
Primary practice location
1241 Vine St
Suite 300
Philadelphia, PA 19107-1111
Mailing address
1241 Vine St
Philadelphia, PA 19107-1111
Phone (215) 405-2100
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS 006981 L | PA | MD | Forensic Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430265600000",
"number": "1801943469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 VINE ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191071111",
"telephone_number": "215-405-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1241 VINE ST",
"address_2": "SUITE 300",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191071111",
"telephone_number": "215-405-2100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "WILLIAM",
"middle_name": "F.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2015-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "PA",
"license": "PS 006981 L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.