DR. JIM RUSSELL (NPI# 1275711459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275711459 |
| Entity Type | Individual |
| Full Name | DR. JIM RUSSELL |
| Credential | PH.D. |
| Practice Address |
777 Craig Rd Ste 200 Saint Louis MO 63141-7190 |
| Practice Telephone | 3149638862 |
| Practice Fax Number | 3149188943 |
| Mailing Telephone | 3149638862 |
| Mailing Fax Number | 3149188943 |
| Enumeration Date | 2008-02-10 |
| Last Update Date | 2016-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 001736 | MO | Behavioral Health & Social Service Providers |
| Street Address |
777 CRAIG RD STE 200 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63141-7190 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861644 | Barbara Schuver | Counselor | 1709 Rosearbor Dr, Saint Louis, MO 63146-4724 | 2020-11-04 |
| 1255946356 | Jessika Triplett | Counselor | 9909 Manchester Rd # 134, Saint Louis, MO 63122-1915 | 2020-09-15 |
| 1629689344 | Jennifer Walsh | Counselor | 5704 Rosa Ave, Saint Louis, MO 63109-3256 | 2020-08-14 |
| 1952910408 | Tiffany Wingo | Counselor | 4143 California Ave, Saint Louis, MO 63118-4507 | 2020-07-29 |
| 1952922528 | Kevin Mcculloch | Counselor | 4100 Forest Park Ave Apt 423, Saint Louis, MO 63108-2897 | 2020-05-05 |
| 1659912954 | Merrick Hughes | Counselor | 2800 Stoddard St Apt 201, Saint Louis, MO 63106-2211 | 2019-10-08 |
| 1821649757 | John Lucas | Counselor | 200 S Bemiston Ave Ste 101, Saint Louis, MO 63105-1915 | 2019-09-23 |
| 1841840618 | Christa Elizabeth Walker | Counselor | 12360 Manchester Rd Ste 100, Saint Louis, MO 63131-4312 | 2019-09-13 |
| 1477013944 | Wonakee Terrisita Robinson Jr. | Counselor | 5950 Drury Ln, Saint Louis, MO 63147-1112 | 2019-03-21 |
| 1952884397 | Marni A Deutsch | Counselor | 7751 Carondelet Ave Ste 600b, Saint Louis, MO 63105-4043 | 2018-09-12 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63141 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.