GERALD LEE RUSSELL (NPI# 1326040148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326040148 |
| Entity Type | Individual |
| Full Name | GERALD LEE RUSSELL |
| Credential | PHD |
| Practice Address |
713 6th St Las Vegas NM 87701-4359 |
| Mailing Address |
Po Box 1705 Las Vegas NM 87701-1705 |
| Practice Telephone | 5054294679 |
| Practice Fax Number | 5054253370 |
| Mailing Telephone | 5054542202 |
| Mailing Fax Number | 5054542211 |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 761 | NM | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 76705 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043200603 | Gerald Thomas Russell | Family Medicine | 11130 Kingston Pike, Suite 7&8, Farragut, TN 37934-2865 | 2005-10-25 |
| Street Address |
713 6TH ST |
| City | LAS VEGAS |
| State | NM |
| Zip Code | 87701-4359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922166651 | Mignon Elisse Mcnicol | Social Worker | 713 6th St, Las Vegas, NM 87701 | 2006-12-05 |
| 1639245913 | Brian Christopher Partridge | Counselor | 713 6th St, Office #2, Las Vegas, NM 87701-4359 | 2006-11-28 |
| 1497857338 | James Michael Kavanaugh | Psychologist | 713 6th St, Las Vegas, NM 87701-4359 | 2006-09-01 |
| 1659381036 | Judy Long | Social Worker | 713 6th St, Las Vegas, NM 87701-4359 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851884423 | Nueva Vida Counseling and Consulting Services LLC | Community/Behavioral Health | Nueva Vida Counseling & Consulting Services LLC, 1920 7th Street, Las Vegas, NM 87701 | 2018-06-08 |
| 1316475403 | El Centro Family Health | Family Medicine | 475 Legion Dr., Las Vegas, NM 87701 | 2017-06-01 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1013369222 | Home Medical Equipment Specialists,llc | Durable Medical Equipment & Medical Supplies | 514 8th Street, Las Vegas, NM 87701 | 2016-07-12 |
| 1750730826 | John Michael Tourangeau | Social Worker | 1920 7th Street, Las Vegas, NM 87701 | 2016-06-08 |
| 1154705689 | Lindsy Laura Kragt Allen | Podiatrist | 1608 7th St, Las Vegas, NM 87701 | 2015-07-14 |
| 1023409521 | Ambercare Medical Supply | Durable Medical Equipment & Medical Supplies | 1747 N Grand Ave, Las Vegas, NM 87701 | 2015-02-05 |
| 1538561964 | El Centro Family Health | Clinic/Center | 947 Old National Road, Las Vegas, NM 87701 | 2014-09-17 |
| 1164832150 | Plaza Drugs | Pharmacist | 178 Bridge St, Las Vegas, NM 87701 | 2014-04-30 |
| 1043648165 | Open Doors Home Health Care | Home Health | 713 Railroad Ave., Las Vegas, NM 87701 | 2013-10-29 |
| Find all providers in zip 87701 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295288553 | Board of Regents Nevada System of Higher Education | Clinical Neuropsychologist | 630 S. Rancho, Ste. A, Las Vegas, NV 89106 | 2016-08-03 |
| 1295288967 | Ivan Hronek | Clinical Neuropsychologist | 7341 W Charleston Blvd Ste 150, Las Vegas, NV 89117-1578 | 2016-07-29 |
| 1124387816 | Marisa Hendron | Clinical Neuropsychologist | 1820 E. Warm Springs Rd, Suite 115, Las Vegas, NV 89119-4680 | 2012-05-15 |
| 1780916130 | High Plains Neuropsychology Associates PC | Clinical Neuropsychologist | 1101 Douglas Ave, Las Vegas, NM 87701-3932 | 2010-02-10 |
| 1326373960 | Nicole Ann Cavenagh | Clinical Neuropsychologist | 3211 E Warm Springs Rd, Las Vegas, NV 89120-3157 | 2009-10-15 |
| 1992840789 | Marilyn J Strada | Clinical Neuropsychologist | 8565 S Eastern Ave Ste 152, Las Vegas, NV 89123-2906 | 2007-02-20 |
| 1932298023 | Staci Ross | Clinical Neuropsychologist | 716 S 6th St, Las Vegas, NV 89101-6922 | 2006-10-12 |
| 1023125325 | David Lee Hopper | Clinical Neuropsychologist | 4550 W Oakey Blvd, Suite # 106, Las Vegas, NV 89102-1581 | 2006-08-23 |
| 1710443163 | Christina Gerhardstein Wong | Clinical Neuropsychologist | 888 W Bonneville Ave, Las Vegas, NV 89106 | 2019-02-11 |
| 1508379025 | Sunshine Collins LLC | Clinical Neuropsychologist | 9163 W Flamingo Rd Ste 120, Las Vegas, NV 89147-6458 | 2017-11-06 |
| Find all providers in LAS VEGAS | ||||
Please comment or provide details below to improve the information on GERALD LEE RUSSELL.
| 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.