GARY LEE RUSSELL LPCC-S, LICDC
NPI 1003394180
Counselor - Mental Health in Mansfield, OH

Q: What is Gary Russell's NPI number?

The NPI number for Gary Russell is 1003394180. It was assigned to this individual provider in the NPPES registry on August 1, 2018.

Q: What is Gary Russell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Gary Russell was last updated on February 15, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 01, 2018PECOS Enrolled

151 MARION AVE, MANSFIELD, OH 44903(419) 774-9969 Get Directions Write a Review

NPPES record last updated: February 15, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Gary Lee Russell Lpcc-s, Licdc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARY LEE RUSSELL LPCC-S, LICDC (NPI 1003394180) is an individual mental health provider in Mansfield, Ohio, licensed in Ohio (E.2001844-SUPV) and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1003394180

Entity TypeIndividualMale

Primary Taxonomy101YM0800X

Provider Legal NameGARY LEE RUSSELLCredential: LPCC-S, LICDC

Location Address151 MARION AVEMansfield, OH 44903-2223

Mailing Address33 S Lexington Springmill RdOntario, OH 44906-1325 · (419) 528-8008 · Fax (877) 486-1420

Phone(419) 774-9969

Sole ProprietorYes

Medical School CMSOtherGraduated 2002

Enumeration DateAugust 1, 2018

Last NPPES UpdateFebruary 15, 2024

NPPES CertifiedFebruary 13, 2024

✔ NPI 1003394180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in OH · E.2001844-SUPV

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License LICDC.162577 (OH)

151 MARION AVE, Mansfield, OH 44903

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include MedMutual, Oscar Health Insurance, Oscar Insurance Corporation of Ohio and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gary Lee Russell Lpcc-s, Licdc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3274070073

PECOS Enrollment IDI20240729004342

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PATRICK RAY EUTSEY

Peer Specialist