MR. MARK STEPHEN RUSSELL JR. (NPI# 1154767267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154767267 |
| Entity Type | Individual |
| Full Name | MR. MARK STEPHEN RUSSELL JR. |
| Credential | LPC |
| Practice Address |
3901 Airport Fwy Ste 107 Bedford TX 76021-6117 |
| Practice Telephone | 8178122880 |
| Practice Fax Number | 8178123096 |
| Mailing Telephone | 8178122880 |
| Mailing Fax Number | 8178123096 |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2020-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
76034 | TX | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831710771 | Mark William Russell | Dentist | 461 Western Blvd Ste 104, Jacksonville, NC 28546-7637 | 2020-05-01 |
| 1144752221 | Mark Russell | Social Worker | 475 Sykesville Troutville Rd, Punxsutawney, PA 15767-4367 | 2017-03-29 |
| 1437314366 | Mark William Russell | Community Health Worker | 108 Schooner Landing Dr, Edenton, NC 27932-8833 | 2008-07-21 |
| 1306867049 | Mark Duane Russell | Specialist/Technologist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2006-07-21 |
| 1639137540 | Mark Russell | Internal Medicine | 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 | 2006-05-02 |
| 1689671315 | Mark Dale Russell | Chiropractor | 5309 44th St, Lubbock, TX 79414-1321 | 2005-07-07 |
| 1154827756 | Mark Russell | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-04-03 |
| 1033654967 | Mark Russell | Pharmacist | 2920 Knoxville Center Dr, Knoxville, TN 37924-2013 | 2017-01-02 |
| 1477097392 | Mark Russell | Social Worker | 302 S Spring St, Tupelo, MS 38804-4853 | 2016-12-12 |
| 1134463870 | Mark Joseph Russell | Occupational Therapist | 275 East Main Street, Frankfort, KY 40621-0001 | 2012-11-19 |
| Street Address |
3901 AIRPORT FWY STE 107 |
| City | BEDFORD |
| State | TX |
| Zip Code | 76021-6117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891349080 | Ana Nicolalde | Counselor | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2019-07-26 |
| 1952889644 | Lauren Ashley Lopez | Marriage & Family Therapist | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2018-08-03 |
| 1699282293 | Leslie Lynn Walden | Counselor | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2018-01-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357851 | Crystal Le | Pharmacist | 4121 E Hardwood Rd, Bedford, TX 76021 | 2020-08-17 |
| 1114544095 | Morgan Sanders | Physical Therapist | 2419 Tx 121, Bedford, TX 76021 | 2020-06-26 |
| 1669938171 | Tracie Thomas | Nurse Practitioner | 3901 Airport Freeway, Suite 230, Bedford, TX 76021 | 2019-02-20 |
| 1346710928 | Bedford Pharmacy LLC | Pharmacy | 2816 Central Dr Ste 160, Bedford, TX 76021 | 2018-11-27 |
| 1861973562 | Healogix Consultants, LLC | Pharmacy | 601-1 Harwood Rd, Bedford, TX 76021 | 2018-08-22 |
| 1851870570 | Artie Lee Nolen | Licensed Vocational Nurse | 1415 Shady Ln, Bedford, TX 76021 | 2018-08-13 |
| 1821510496 | Gabriela D Driskill | Counselor | 201 E. 9th Street, Dallas, TX 76021 | 2017-07-14 |
| 1588190938 | Tdc-bedford Dialysis Clinic LLC | Clinic/Center | 725 N Industrial Blvd, Ste 100, Bedford, TX 76021 | 2017-05-04 |
| 1801246673 | Tamara Allen-wolf, LLC | Counselor | 2217 Martin Dr., Ste 200, Bedford, TX 76021 | 2016-06-13 |
| 1013399799 | Nirvana Dental | Clinic/Center | 3704 Cheek Sparger Road #100, Bedford, TX 76021 | 2015-06-18 |
| Find all providers in zip 76021 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831705698 | Joseph Vincent Burke | Counselor | 612 3rd St Apt B8, Bedford, VA 24523-1901 | 2020-09-17 |
| 1013551191 | Kristin Bruce-cardwell | Counselor | 2700 Tibbets Dr Ste 504, Bedford, TX 76022-5916 | 2019-11-01 |
| 1669016127 | Amanda Winebarger | Counselor | 5217 Peaks Rd, Bedford, VA 24523-3737 | 2019-10-28 |
| 1063995686 | Rim Endeavors, LLC | Counselor | 209 N Industrial Blvd Ste 237, Bedford, TX 76021-6128 | 2018-09-10 |
| 1497264006 | Gwendolyn Kay Bain | Counselor | 2125 Martin Dr Ste 100, Bedford, TX 76021-5992 | 2017-09-26 |
| 1184164261 | Deborah Delaney | Counselor | 315 N Bridge St, Bedford, VA 24523-1927 | 2017-03-08 |
| 1174982615 | Kathy Davis Haecker | Counselor | 209 N Industrial Blvd, Suite 237, Bedford, TX 76021-6128 | 2016-02-12 |
| 1619375433 | Michelle Price | Counselor | 806 E Main St Ste 200, Bedford, VA 24523-2939 | 2014-12-10 |
| 1750703534 | Lafonya Jones | Counselor | 1264 Harwood Rd Ste 175, Bedford, TX 76021-4270 | 2014-01-13 |
| 1366872590 | Whitney Lenore Scheef | Counselor | 1244 Harwood Rd, Suite 120, Bedford, TX 76021-4244 | 2013-11-25 |
| Find all providers in BEDFORD | ||||
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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.