THERESA M. RUSSELL (NPI# 1457750895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457750895 |
| Entity Type | Individual |
| Full Name | THERESA M. RUSSELL |
| Credential | LPC |
| Practice Address |
428 S 36th St Quincy IL 62301-5924 |
| Mailing Address |
900 E Laharpe St Kirksville MO 63501-4520 |
| Practice Telephone | 2172246300 |
| Practice Fax Number | 2172244329 |
| Mailing Telephone | 6606651962 |
| Mailing Fax Number | 6606653989 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
178008281 | IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295266674 | Theresa Russell | Social Worker | 350 N Federal Hwy, 715, Boynton Beach, FL 33435-4171 | 2017-03-27 |
| 1023372992 | Theresa Delores Russell | Physical Therapy Assistant | 11577 Rio Secco Rd, Peyton, CO 80831-4031 | 2012-06-26 |
| 1629061981 | Theresa A Russell | Nurse Practitioner | 406 Ne 1st St, Enterprise, OR 97828-1168 | 2005-08-23 |
| 1487808119 | Theresa Russell | Nurse Practitioner | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-11-07 |
| 1255465530 | Theresa Joanne Russell | Specialist | 5494 Pony Express Trail, Pollock Pines, CA 95726 | 2007-03-16 |
| Street Address |
428 S 36TH ST |
| City | QUINCY |
| State | IL |
| Zip Code | 62301-5924 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841699246 | Jeanna B. Parkhill | Counselor | 428 S 36th St, Quincy, IL 62301-5924 | 2014-08-21 |
| 1083240741 | Charmaine D Coffman-williams | Licensed Practical Nurse | 428 S 36th St, Quincy, IL 62301-5924 | 2020-03-13 |
| 1689232704 | Preferred Family Healthcare, Inc. | Community/Behavioral Health | 428 S 36th St, Quincy, IL 62301-5924 | 2019-06-04 |
| 1154873305 | Kathleen Brink | Counselor | 428 S 36th St, Quincy, IL 62301-5924 | 2016-11-03 |
| 1811369820 | Michael Smart | Social Worker | 428 S 36th St, Quincy, IL 62301-5924 | 2015-10-29 |
| 1265819635 | Preferred Family Healthcare, Inc. | Substance Abuse Rehabilitation Facility | 428 S 36th St, Quincy, IL 62301-5924 | 2015-05-05 |
| 1083091458 | Preferred Family Healthcare, Inc. | Substance Abuse Rehabilitation Facility | 428 S 36th St, Quincy, IL 62301-5924 | 2015-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356969471 | Lutheran Child and Family Service of Illinois | Foster Care Agency | 1400 N. 30th St, Quincy, IL 62301 | 2020-07-07 |
| 1134749716 | Bethany Nicole Jumps | Pharmacist | Broadway St & N 11th St, Quincy, IL 62301 | 2020-04-23 |
| 1043844293 | S.crider Construction An Supply Corp. | Contractor | 529 Woodbridge Dr., Quincy, IL 62301 | 2020-02-26 |
| 1245862002 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 3301 Broadway St., Quincy, IL 62301 | 2020-02-10 |
| 1043851488 | West Central Illinois Nutrition | In Home Supportive Care | 639 York St. Room 333, Quincy, IL 62301 | 2019-10-07 |
| 1861986549 | Quincy Physicians & Surgeons Clinic, Sc | Internal Medicine | 3347 Broadway St, Quincy, IL 62301 | 2018-06-18 |
| 1194255083 | Michael Andrew Behrens | Nurse Practitioner | Broadway and 11th Street, Quincy, IL 62301 | 2017-06-14 |
| 1770987323 | Kirsty Yvonne Reed | Counselor | 205 S. 24th Street, Chaddock, Quincy, IL 62301 | 2014-10-10 |
| 1114234499 | Dale D. Shahan Dds Ltd | Dentist | 636 Hampshire Suite 102, Quincy, IL 62301 | 2010-09-08 |
| 1730314071 | James D Kaufmann | Pharmacist | 14th & Broadway, Quincy, IL 62301 | 2009-05-15 |
| Find all providers in zip 62301 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194331447 | Mindshift Center, LLC | Counselor | 822 State St Ste 10, Quincy, IL 62301-4961 | 2020-09-22 |
| 1902453285 | Steven Spears | Counselor | 1891 Maine St Ste 5, Quincy, IL 62301-4272 | 2019-08-21 |
| 1982179545 | Bonnie Brod Nytes | Counselor | 620 Maine St, Quincy, IL 62301-3908 | 2018-10-10 |
| 1841699246 | Jeanna B. Parkhill | Counselor | 428 S 36th St, Quincy, IL 62301-5924 | 2014-08-21 |
| 1467706135 | Melissa Ann Milliken | Counselor | 829 Washington St, Quincy, IL 62301-5222 | 2012-11-02 |
| 1952628364 | Jessica Elizabeth Beaston | Counselor | 3120 Kingsridge Dr, Quincy, IL 62301-6241 | 2010-04-24 |
| 1841522513 | Kathy Lynn Buck | Counselor | 1101 S 36th St, Quincy, IL 62301-6005 | 2010-02-05 |
| 1700013422 | Mark L. Vander Ley | Counselor | 822 State St, Suite # 9e, Quincy, IL 62301-4961 | 2009-06-20 |
| 1790866358 | James H. Prow | Counselor | 2272 Chestnut St, Quincy, IL 62301-2215 | 2006-10-18 |
| 1578570164 | Lynn Barbara Mercurio | Counselor | 529 Hampshire St Ste 308, Quincy, IL 62301-2935 | 2006-08-03 |
| Find all providers in QUINCY | ||||
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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.