RUSSELL MOODY (NPI# 1871062372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871062372 |
| Entity Type | Individual |
| Full Name | RUSSELL MOODY |
| Practice Address |
37875 Jasper Lowell Rd Jasper OR 97438-9751 |
| Practice Telephone | 5417471235 |
| Practice Fax Number | 5417474722 |
| Mailing Telephone | 5417471235 |
| Mailing Fax Number | 5417474722 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2018-11-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
37875 JASPER LOWELL RD |
| City | JASPER |
| State | OR |
| Zip Code | 97438-9751 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497821680 | Jasper Mountain | Residential Treatment Facility, Emotionally Disturbed Children | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2006-11-28 |
| 1013518117 | Taylor Lyn Sorensen | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-11-04 |
| 1871107425 | Cody L Lee | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-09-01 |
| 1639782535 | Madison H Correia | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-28 |
| 1558974832 | Laurel Louise King | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-26 |
| 1477165348 | Larkin Marie Lowry | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-20 |
| 1093325789 | Brittany Szalkiewicz | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-06 |
| 1578171930 | Jaida Lilian Hardinger | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-07-21 |
| 1700408135 | Sara Katelyn Walz | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-05-07 |
| 1245861590 | Rachael Ridel Bennett | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225151707 | Hyla M Dobaj | Counselor | 37875 Jasper Lowell Rd., Jasper, OR 97438 | 2007-04-09 |
| 1134370406 | Benjamin Daniel Lane George | Counselor | 37446 Jasper Lowell Rd, Jasper, OR 97438-9719 | 2008-10-06 |
| 1528219862 | Julie R. Simmonds | Counselor | 39477 Little Fall Creek Rd, Fall Creek, OR 97438-9726 | 2008-10-06 |
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730648270 | Melissa Russell | Counselor | 205 Oakhill Rd Ste A, Jasper, AL 35504-7416 | 2019-03-14 |
| 1104392414 | Jason King | Counselor | 257 Brucke Strasse, Jasper, IN 47546-3400 | 2018-10-15 |
| 1689123242 | Jennifer Terry | Counselor | 85 N Walston Bridge Rd, Jasper, AL 35504-8640 | 2016-09-23 |
| 1558787853 | Christine Vaal | Counselor | 671 3rd Ave Ste G, Jasper, IN 47546-3653 | 2014-03-11 |
| 1134370406 | Benjamin Daniel Lane George | Counselor | 37446 Jasper Lowell Rd, Jasper, OR 97438-9719 | 2008-10-06 |
| 1225151707 | Hyla M Dobaj | Counselor | 37875 Jasper Lowell Rd., Jasper, OR 97438 | 2007-04-09 |
| 1912063033 | Ronald D. Bray | Counselor | 912 Airport Rd S, Jasper, AL 35501-4750 | 2007-01-01 |
| 1013518117 | Taylor Lyn Sorensen | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-11-04 |
| 1871107425 | Cody L Lee | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-09-01 |
| 1639782535 | Madison H Correia | Counselor | 37875 Jasper Lowell Rd, Jasper, OR 97438-9751 | 2020-08-28 |
| Find all providers in JASPER | ||||
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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.