RUSSELL T HOUSE (NPI# 1114365293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114365293 |
| Entity Type | Individual |
| Full Name | RUSSELL T HOUSE |
| Credential | LPE |
| Practice Address |
60 W Sunbridge Dr Fayetteville AR 72703-1822 |
| Mailing Address |
2400 S 48th St Springdale AR 72762-6683 |
| Practice Telephone | 4796951240 |
| Practice Fax Number | 4797504843 |
| Mailing Telephone | 4797502020 |
| Mailing Fax Number | 4797504843 |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-07-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC1900X |
Psychologist Specialization: Counseling |
13-45E | AR | Behavioral Health & Social Service Providers |
| Street Address |
60 W SUNBRIDGE DR |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72703-1822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992743942 | Joyce Marie Prowell | Social Worker | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2006-06-03 |
| 1487255717 | Kati Street | Counselor | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-11-03 |
| 1053912360 | Kaitlyn Smith | Social Worker | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-11-03 |
| 1508467838 | Taylor Williams | Case Manager/Care Coordinator | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-11-03 |
| 1073112264 | Monica Vasiloff | Case Manager/Care Coordinator | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-10-20 |
| 1720687981 | Taylor Walker | Counselor | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-10-20 |
| 1740889906 | Catherine Rievert | Social Worker | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-10-20 |
| 1215534268 | Adam Kelley | Case Manager/Care Coordinator | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-10-02 |
| 1710591631 | Haley Martin | Case Manager/Care Coordinator | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-09-08 |
| 1649884560 | Henry Smith | Counselor | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2020-09-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154391 | Margaret Sorrells | Pharmacist | 3909 N Mall Ave Attn:pharmacy, Fayetteville, AR 72703 | 2020-11-06 |
| 1497369631 | Justin A Rand | Massage Therapist | 88 W Colt Square Dr, Fayetteville, Ar 72703, Fayetteville, AR 72703 | 2020-09-04 |
| 1235777558 | Washington Regional Medical System | Specialist | 3264 N North Hills Blvd, Fayetteville, AR 72703 | 2019-12-17 |
| 1760024582 | Haley Brooke Thompson | Occupational Therapist | 2474 E Joyce Blvd Ste 2, Null, Fayetteville, AR 72703 | 2019-10-14 |
| 1306492129 | Bhg L, LLC | Clinic/Center | 8 Colt Square Drive, Fayetteville, AR 72703 | 2019-08-16 |
| 1306406269 | Idell Marie Mitchell | Optometrist | Eye Clinic, 1100 N College Ave, Fayetteville, AR 72703 | 2019-06-13 |
| 1821574815 | Toni Myer | Nurse Practitioner | 3 E Appleby Rd Ste 101, Fayetteville, AR 72703 | 2018-07-13 |
| 1306340393 | Josh Kelfer | Student in an Organized Health Care Education/Training Program | 1125 North College Avenue, Fayetteville, AR 72703 | 2018-03-22 |
| 1649726449 | Vantage Point of Nwa | Community/Behavioral Health | 4171 N. Crossover Rd, Fayetteville, AR 72703 | 2016-08-31 |
| 1386097137 | Jason Nordstrom | Speech-Language Pathologist | 2664 N Valencia Ave, Fayetteville, AR 72703 | 2016-07-18 |
| Find all providers in zip 72703 | ||||
| Taxonomy Code | 103TC1900X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Counseling |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051573 | Latoya Crane | Psychologist | 260 Rock Hill Dr, Fayetteville, GA 30215-4953 | 2020-10-20 |
| 1033737465 | Kindred Care Therapy | Psychologist | 213 Dick St Ste 200, Fayetteville, NC 28301-5771 | 2020-07-13 |
| 1740634435 | Crystal Susan Rofkahr | Psychologist | 26 E Meadow St Ste 3, Fayetteville, AR 72701 | 2016-04-19 |
| 1912383233 | Lee Lytton | Psychologist | 2537 Raeford Rd, Suite D, Fayetteville, NC 28305-5095 | 2015-08-10 |
| 1659583599 | Shirley Marie Broadwater | Psychologist | 1111 Houser Rd, Fayetteville, PA 17222-9731 | 2007-05-04 |
| 1336107267 | Loleta Wood Foster | Psychologist | 5114 Yadkin Rd, #120, Fayetteville, NC 28303-3251 | 2006-05-02 |
| 1538513221 | Dr C S Rofkahr Pllc | Psychologist | 1 W Sunbridge Dr, Fayetteville, AR 72703-1825 | 2016-04-19 |
| 1225375553 | Allie Frances Wakefield | Psychologist | 60 W Sunbridge Dr, Fayetteville, AR 72703-1822 | 2013-01-07 |
| 1225391444 | Tamara Ulysse | Psychologist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2012-06-21 |
| 1043588239 | Tiffany Nicole Gatling | Psychologist | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2011-12-02 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72703 |
Please comment or provide details below to improve the information on RUSSELL T HOUSE.
| 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.