Organization Active NPI

Russ Pool Psychotherapy, LLC

  • Professional Counselor
  • Durango, CO
National Provider Identifier
1831726769
Registry record updated Mar 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
RUSS POOL PSYCHOTHERAPY, LLC
Practice address
1911 Main Ave Ste 258
Durango, CO 81301-5083
Phone
(970) 375-7777
NPI assigned
Mar 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2020

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

Authorized official

Name
Russ Pool
Title
Owner
Phone
(970) 375-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

1911 Main Ave Ste 258
Durango, CO 81301-5083

Mailing address

34 Lewis Mountain LN
Durango, CO 81301-6530

National Provider Directory

National Provider Directory

Locations

1911 Main Ave
Ste 258
Durango, CO 81301
Phone (575) 534-2856

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584921600000",
    "number": "1831726769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LEWIS MOUNTAIN LN",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813016530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 MAIN AVE STE 258",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813015083",
            "telephone_number": "970-375-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSS POOL PSYCHOTHERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-23",
        "last_updated": "2020-03-23",
        "certification_date": "2020-03-23",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-375-7777"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durango, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2020; 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.