CONNIE RUSSELL (NPI# 1447691167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447691167 |
| Entity Type | Individual |
| Full Name | CONNIE RUSSELL |
| Credential | CSAC |
| Practice Address |
712 55th St Kenosha WI 53140-6506 |
| Mailing Address |
5407 8th Ave Kenosha WI 53140-3715 |
| Practice Telephone | 2628420538 |
| Mailing Telephone | 2626577188 |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1915-132 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518509637 | Connie Russell | Registered Nurse | 1205 E Bonner Way, Salt Lake City, UT 84117-4917 | 2019-10-09 |
| 1649630856 | Connie Russell | Public Health or Welfare | 502 S Choctaw Ave, Wapanucka, OK 73461-9235 | 2016-03-01 |
| 1063797587 | Connie Lee Russell | Pharmacist | 2244 Murfreesboro Rd, Nashville, TN 37217-3313 | 2011-10-16 |
| Street Address |
712 55TH ST |
| City | KENOSHA |
| State | WI |
| Zip Code | 53140-6506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306917570 | Mathew Sean Mccarthy | Psychiatry & Neurology | 712 55th St, Kenosha, WI 53140-6506 | 2006-11-10 |
| 1003350422 | La Shanda Tolefree | Counselor | 712 55th St, Kenosha, WI 53140-6506 | 2016-12-05 |
| 1912441338 | Kristin Joy Stensgard | Counselor | 712 55th St, Kenosha, WI 53140-6506 | 2016-12-05 |
| 1265870323 | Vicki Lynn Smith | Social Worker | 712 55th St, Kenosha, WI 53140-6506 | 2013-06-11 |
| 1326179987 | Mathew Mccarthy, Md, Sc | Clinic/Center | 712 55th St, Kenosha, WI 53140-6506 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663396 | Lydia Zopf | Counselor | 2001 Alford Park Dr., Carthage College, Kenosha, WI 53140 | 2020-03-09 |
| 1952949406 | Rotate Rehabilitation and Performance | Physical Therapist | 5606 6th Avenue Suite Ll9, Kenosha, WI 53140 | 2019-12-16 |
| 1134778590 | Brenda Chiapetta | Registered Nurse | 3233 23rd Ave, Kenosha, WI 53140 | 2019-09-09 |
| 1275003394 | Kimberly Shaffner | Family Medicine | 4536 22nd Avenue, Kenosha, WI 53140 | 2018-12-01 |
| 1659863389 | Bart L Mengo | Contractor | 1715 60th Street, Kenosha, WI 53140 | 2018-05-30 |
| 1093182941 | Guided Wellness Counseling | Community/Behavioral Health | 1112 56th St, Kenosha, WI 53140 | 2015-08-26 |
| 1376970764 | Stacey L Andersen | Acupuncturist | 5603 7th Ave, Kenosha, WI 53140 | 2013-10-01 |
| 1841467438 | Deborah Schwerdtfeger | Occupational Therapy Assistant | 3415 Sheridan Road, Woodstock Rehab Dept, Kenosha, WI 53140 | 2008-05-13 |
| 1942492020 | Rebecca Ann Burdette | Counselor | 920 60th Street, Renosha, WI 53140 | 2007-08-13 |
| 1851598619 | Aurora Medical Group, Inc. | Durable Medical Equipment & Medical Supplies | 2707 15th Place, Kenosha, WI 53140 | 2007-06-27 |
| Find all providers in zip 53140 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144785395 | Michael L Wrzesinski | Counselor | 4109 67th Street, Kenosha, WI 53142 | 2019-02-01 |
| 1255877148 | Amanda Sherman | Counselor | 6321 23rd Ave, Kenosha, WI 53143-4801 | 2017-01-16 |
| 1326416355 | Donna Jorgensen | Counselor | 815 57th St Unit I, Kenosha, WI 53140-4062 | 2015-09-08 |
| 1275959157 | Nancy Guadagno | Counselor | 6123 Green Bay Rd Ste 240, Kenosha, WI 53142-2927 | 2014-03-14 |
| 1922389352 | Morgan Brittany Diaz | Counselor | 6711 29th Ave, Kenosha, WI 53143-4650 | 2011-08-30 |
| 1609076322 | Eileen G Warren | Counselor | 6501 3rd Ave, Kenosha, WI 53143-5111 | 2007-07-20 |
| 1619024262 | Professional Services Group, Inc. | Counselor | 6233 39th Ave, Kenosha, WI 53142-7015 | 2007-01-05 |
| 1861572372 | Carol Bell | Counselor | 4003 80th St, Suite 101, Kenosha, WI 53142-4995 | 2006-10-17 |
| 1609982040 | Brian A Wolf | Counselor | 2108 63rd St, Kenosha, WI 53143-4454 | 2006-08-21 |
| 1831103761 | Nicholas R Mayor | Counselor | 3535 30th Avenue, Suite 202, Kenosha, WI 53144 | 2006-07-28 |
| Find all providers in KENOSHA | ||||
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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.