Active NPI
Kelly Marie Spegel Russell, PH.D.
- Psychologist
- Wyoming, MI
National Provider Identifier
1992179535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301016993
- Practice address
- 1055 Gezon Pkwy SW
Wyoming, MI 49509-9542 - Phone
- (616) 773-2908
- Fax
- (616) 532-3046
- NPI assigned
- Nov 19, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301016993 | MI | Primary |
Addresses
Primary practice location
1055 Gezon Pkwy SW
Wyoming, MI 49509-9542
Mailing address
1055 Gezon Pkwy SW
Wyoming, MI 49509-9542
Phone (616) 773-2908
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 |
|---|---|---|---|
| 6301016993 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anne Parpas Counseling LLC | Psychologist | Past | 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": "1447891200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704326400000",
"number": "1992179535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 GEZON PKWY SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495099542",
"telephone_number": "616-773-2908",
"fax_number": "616-532-3046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 GEZON PKWY SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "495099542",
"telephone_number": "616-773-2908",
"fax_number": "616-532-3046"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KELLY",
"middle_name": "MARIE SPEGEL",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-19",
"last_updated": "2024-01-04",
"certification_date": "2024-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301016993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wyoming, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.