DR. MICHAEL LEE RUSSELL SR. (NPI# 1255304887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255304887 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL LEE RUSSELL SR. |
| Credential | PH.D. |
| Practice Address |
Hq, Tradoc, Suite 412 Atbo-m Bldg 82, 60 Ingalls Road Fort Monroe VA 23651-1032 |
| Mailing Address |
454 Gulick Dr. Apartment B Fort Monroe VA 23651 |
| Practice Telephone | 7577882229 |
| Practice Fax Number | 7577882962 |
| Mailing Telephone | 7577882229 |
| Mailing Fax Number | 7577882962 |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103G00000X | Clinical Neuropsychologist | PY00002256 | WA | Behavioral Health & Social Service Providers |
| X | 103TC0700X |
Psychologist Specialization: Clinical |
PY00002256 | WA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1518279215 | Michael Russell | Psychologist | 4951 Chambers Street - 6th Floor, Ny, NY 10007-1209 | 2010-07-10 |
| 1245414093 | Michael Russell | Non-emergency Medical Transport (VAN) | 4588 N 23rd St, Milwaukee, WI 53209-6201 | 2007-12-27 |
| 1124242821 | Michael Dennis Russell | Chiropractor | 1164 Monroe St, Suite #1, Salinas, CA 93906-3565 | 2007-04-12 |
| 1831282441 | Michael Guy Russell | Social Worker | 8 West Monroe, #907, Chicago, IL 60603 | 2006-10-02 |
| 1962502880 | Michael A Russell | Chiropractor | 18624 Detroit Ave, Lakewood, OH 44107-3202 | 2006-09-22 |
| 1134139157 | Michael A Russell | Dentist | 2240 N Highway 89, Suite A, Harrisville, UT 84404-2651 | 2006-08-09 |
| 1285640128 | Michael Russell | Counselor | 207 Rock Prairie Rd, Suite B, College Station, TX 77845-8777 | 2006-07-31 |
| 1174164222 | Michael Cody Russell | Counselor | 1235 E St, Fresno, CA 93706-2024 | 2019-09-30 |
| 1710484472 | Michael David Russell | Student in an Organized Health Care Education/Training Program | University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242 | 2018-04-10 |
| Street Address |
HQ, TRADOC, SUITE 412 ATBO-M BLDG 82, 60 INGALLS ROAD |
| City | FORT MONROE |
| State | VA |
| Zip Code | 23651-1032 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821294729 | Mcdonald Army Health Center | Clinic/Center | Building 82 Ingals, Fort Monroe, VA 23651 | 2007-06-26 |
| 1386743409 | Mcdonald Army Health Center | Pharmacy | Ingalls Rd Bldg 82, Ft Monroe, VA 23651 | 2006-09-22 |
| 1750997441 | Adrienne Reddick | Nurse Practitioner | 17 Moat Walk Unit 140a, Fort Monroe, VA 23651-1020 | 2020-09-18 |
| 1538679352 | Artisan Counseling | Counselor | 11 Moat Walk, Fort Monroe, VA 23651-1020 | 2017-10-06 |
| 1386163368 | Virginia Chiropractic & Wellness | Chiropractor | 4 Reeder Cir Apt 35b, Fort Monroe, VA 23651-1027 | 2017-09-12 |
| 1952465981 | Ronald Ellyson | Physician Assistant | 60 Ingalls Rd Bldg 82, Ste. 412, Fort Monroe, VA 23651-1032 | 2006-12-21 |
| 1740267962 | Peter David Cross | Family Medicine | 60 Ingalls Rd, Craven Army Health Clinic, Fort Monroe, VA 23651-1032 | 2005-12-29 |
| 1821202151 | Mcdonald Army Health Center | Clinic/Center | 60 Ingalls Rd, Fort Monroe, VA 23651-1032 | 2007-05-09 |
| 1679637235 | Tamara Williams Fox | Family Medicine | 60 Ingalls Rd, Building 82, Fort Monroe, VA 23651-1032 | 2006-12-20 |
| 1023410859 | Kristi Langschied | Physical Therapy Assistant | 2 Fenwick Rd, Fort Monroe, VA 23651-1120 | 2014-09-24 |
| Find all providers in zip 23651 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861008492 | Nicole N Hashemian | Clinical Neuropsychologist | 3040 Williams Dr Ste 402, Fairfax, VA 22031-4618 | 2020-09-18 |
| 1447877527 | Sabrina Kate Jennings | Clinical Neuropsychologist | 8100 Innovation Park Dr, Fairfax, VA 22031-4870 | 2020-07-06 |
| 1831710755 | Reston Precision Neuropsychology LLC | Clinical Neuropsychologist | 441-d Carlisle Dr., Suite 103, Herndon, VA 20170-4802 | 2020-05-01 |
| 1841848504 | Dr Vivian Begali Lcp Facpn Abn Abpp LLC | Clinical Neuropsychologist | 9327 Midlothian Tpke Ste 1c, North Chesterfield, VA 23235-4965 | 2019-08-27 |
| 1528527140 | Natalia Lugina Mauranne | Clinical Neuropsychologist | 441d Carlisle Dr., Suite 103, Herndon, VA 20170-4802 | 2019-03-13 |
| 1518434604 | Jessica Isabel Alva | Clinical Neuropsychologist | 12735 Inverness Way, Woodbridge, VA 22192-5038 | 2018-10-27 |
| 1447746383 | Hilary Caroline Goetz | Clinical Neuropsychologist | 8505 Arlington Blvd Ste 450, Fairfax, VA 22031-4630 | 2018-07-03 |
| 1851801708 | William David Crews Jr. | Clinical Neuropsychologist | 118 Dreaming Creek Dr, Lynchburg, VA 24502-2735 | 2017-10-05 |
| 1306360425 | Nacmed | Clinical Neuropsychologist | 90 Chatham Heights Rd, Fredericksburg, VA 22405-2566 | 2017-07-31 |
| 1003330408 | Cognitive Consults and Technology LLC | Clinical Neuropsychologist | 3020 Hamaker Court, Suite 103, Neuropsychology Associates of Fairfax, Fairfax, VA 22031 | 2017-07-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT MONROE |
| Zip Code | 23651 |
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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.