JESSIE LEE RUSSELL NPI 1972104735

NPI Information

NPI: 1972104735
Provider Name: JESSIE LEE RUSSELL
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
550 S ALASKA ST STE 202
PALMER, AK
ZIP 99645
Phone: (907) 746-6019
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Jessie Lee Russell is a mental health counselor in Palmer, AK. Jessie Lee Russell NPI is 1972104735. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

550 S ALASKA ST STE 202
PALMER, AK
ZIP 99645-372
Phone: (907) 746-6019
Fax: (907) 745-7565

The enumeration date for this NPI number is 11/6/2020 and was last updated on 11/6/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1811042872	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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