ANDREA M RUSSELL (NPI# 1619115557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619115557 |
| Entity Type | Individual |
| Full Name | ANDREA M RUSSELL |
| Credential | MS, CCC-SLP |
| Practice Address |
634 N Main St Suite 3 O Fallon IL 62269-3733 |
| Practice Telephone | 6186324222 |
| Mailing Telephone | 6186324222 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-01-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 146.009661 | IL | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730699182 | Andrea Russell | Counselor | 20280 Governors Hwy Ste 207, Olympia Fields, IL 60461-1028 | 2017-10-11 |
| 1205267762 | Andrea Russell | Speech-Language Pathologist | 921 Glendora Rd S, Kissimmee, FL 34759-3653 | 2013-12-10 |
| 1487734067 | Andrea W. Russell | Dentist | 8014 Cumming Hwy, Suite 401, Canton, GA 30115-9339 | 2006-10-17 |
| 1992803795 | Andrea Synnestvedt Russell | Social Worker | 800 Cottageview Dr Ste 1076, Traverse City, MI 49684-2614 | 2006-09-20 |
| 1225544380 | Andrea Mary Russell | Registered Nurse | 1010 E and West Rd, West Seneca, NY 14224-3602 | 2017-12-27 |
| 1396297768 | Andrea Russell | Social Worker | 1001 N J St, Tacoma, WA 98403-2125 | 2016-11-01 |
| 1225454846 | Andrea Russell | Behavioral Analyst | 1218 Griegos Rd Nw, Albuquerque, NM 87107-3752 | 2014-03-06 |
| 1770822843 | Andrea Renee Russell | Social Worker | 2325 S Harvard Ave, Tulsa, OK 74114-3300 | 2013-02-08 |
| 1124306576 | Andrea Russell | Social Worker | 1436 S Shelby St, Louisville, KY 40217-1195 | 2011-08-02 |
| 1447568365 | Andrea Russell | Pharmacist | 4881 Sugar Maple Dr, Wpafb, OH 45433-5529 | 2010-09-14 |
| Street Address |
634 N MAIN ST SUITE 3 |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-3733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124044698 | Abc Pediatric Therapy, LLC | Occupational Therapist | 634 N Main St, Suite 3, O Fallon, IL 62269-3746 | 2006-07-15 |
| 1053955906 | Dina Breanne Maxine Woodworth | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-11-04 |
| 1346899317 | Ashley Angela Watschinger | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3751 | 2019-09-11 |
| 1548826316 | Elizabeth Conroy | Speech-Language Pathologist | 634 N Main St, O Fallon, IL 62269-3751 | 2019-05-16 |
| 1730742628 | Dominique Williams | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-04-17 |
| 1235691056 | Sheila Gerilyn Hipskind | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3751 | 2019-04-01 |
| 1215498225 | Sarah Danielle Miller Salzman | Assistant Behavior Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-03-31 |
| 1053885749 | Marlon Van Ham | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2019-01-15 |
| 1245702869 | Mackenzie Archambo | Behavioral Analyst | 634 N Main St, O Fallon, IL 62269-3751 | 2018-12-20 |
| 1689165870 | Kendyl Ann Cuddihee | Behavior Technician | 634 N Main St, O Fallon, IL 62269-3746 | 2018-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215768 | Tracie Lee Beckmann | Speech-Language Pathologist | 731 Falcon Hill Trl, O Fallon, MO 63368-8194 | 2020-11-08 |
| 1134603954 | Kelsey Erin Heisserer | Speech-Language Pathologist | 8970 Mexico Rd, O Fallon, MO 63366-7505 | 2018-09-18 |
| 1558859025 | Kelsey Stradtner | Speech-Language Pathologist | 828 Park Entrance Pl Apt 1, O Fallon, IL 62269-2761 | 2018-04-30 |
| 1053829952 | Victoria Amber Taverner | Speech-Language Pathologist | 6 Eagle Ctr Ste 1, O Fallon, IL 62269-1945 | 2018-01-14 |
| 1760991913 | Caitlyn Schroeder | Speech-Language Pathologist | 522 Savannah Garden Dr, O Fallon, MO 63366-3223 | 2017-09-20 |
| 1063930774 | Kayla Dalene Waterman | Speech-Language Pathologist | 1010 Moye School Rd, O Fallon, IL 62269-6841 | 2017-09-01 |
| 1487171955 | Kathleen Mary Wolf | Speech-Language Pathologist | 505 S Cherry St, O Fallon, IL 62269-2043 | 2017-08-25 |
| 1023534310 | Amy Grosch | Speech-Language Pathologist | 610 Prince Ruppert Dr, O Fallon, MO 63366-1802 | 2017-08-17 |
| 1669997193 | Shane Kapler | Speech-Language Pathologist | 250 Fallon Pkwy, O Fallon, MO 63368-7325 | 2017-08-05 |
| 1316494180 | Kristin Elizabeth Knoop | Speech-Language Pathologist | 150 Waterford Crossing Dr, O Fallon, MO 63368-7135 | 2016-09-08 |
| Find all providers in O FALLON | ||||
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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.