Individual provider Active NPI

Seneca Russell-Rodriguez

  • Marriage & Family Therapist
  • Campbellsville, KY
National Provider Identifier
1922230119
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
173900 Issued in KY
Practice address
107 N Central Ave Ste C
Campbellsville, KY 42718-2034
Phone
(575) 644-8237
NPI assigned
Aug 20, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X T-0148291 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X 0147341 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X 0161871 NM
Addiction (Substance Use Disorder) Counselor 101YA0400X 17401 KY
Marriage & Family Therapist 106H00000X 0168751 NM
Case Manager/Care Coordinator 171M00000X
Marriage & Family Therapist 106H00000X 173900 KY Primary

Addresses

Primary practice location

107 N Central Ave Ste C
Campbellsville, KY 42718-2034

Mailing address

608 Columbia Hwy
Greensburg, KY 42743-1116
Phone (575) 644-8237

Other names 1

  • Mrs. Seneca White Former name

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

LicenseStateTypeSpecialty
17401KYMDAddiction (Substance Use Disorder) Counselor
0147341NMMDAddiction (Substance Use Disorder) Counselor
0161871NMMDAddiction (Substance Use Disorder) Counselor
T-0148291NMMDMental Health Counselor
173900KYMDMarriage & Family Therapist
0168751NMMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart and Soul Counseling Mental Health PastSince Jun 22, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1922230119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 COLUMBIA HWY",
            "city": "GREENSBURG",
            "state": "KY",
            "postal_code": "427431116",
            "telephone_number": "575-644-8237",
            "fax_number": "877-513-3441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N CENTRAL AVE STE C",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427182034",
            "telephone_number": "575-644-8237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL-RODRIGUEZ",
        "first_name": "SENECA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "T-0148291",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0147341",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0161871",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "17401",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NM",
            "license": "0168751",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KY",
            "license": "173900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SENECA",
            "last_name": "WHITE",
            "prefix": "MRS.",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Campbellsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.