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ANDREA RUSSELL
NPI 1104769520
Community/Behavioral Health in Rigby, ID

Active since April 10, 2026
1200 JAYLEE DR UNIT 1, RIGBY, ID 83442(208) 419-9383 Get Directions Write a Review

NPPES record last updated: May 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 13, 2026, Apr 10, 2026 (2 updates tracked since 2026).

About Andrea Russell NPPES

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

ANDREA RUSSELL (NPI 1104769520) is a healthcare organization registered as a community/behavioral health in Rigby, Idaho and active in the NPI registry since April 2026. The organization lists Andrea Russell, Intervention Professional, as its authorized official.

NPPES Registry Identity

NPI1104769520
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameANDREA RUSSELL
Location Address1200 JAYLEE DR UNIT 1Rigby, ID 83442-5273
Mailing Address1200 Jaylee Dr Unit 1Rigby, ID 83442-5273 · (208) 419-9383
Phone(208) 419-9383
Organization SubpartNo
Authorized OfficialAndrea RussellIntervention Professional · (208) 419-9383
Enumeration DateApril 10, 2026
Last NPPES UpdateMay 13, 20262 updates tracked since enumeration
NPPES CertifiedMay 13, 2026
✔ NPI 1104769520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Also ListedDevelopmental TherapistTaxonomy 222Q00000X
1200 JAYLEE DR UNIT 1, Rigby, ID 83442
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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

Other Providers at the Same Location NPPES

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

ANDREA RUSSELL
Developmental Therapist
1200 JAYLEE DR UNIT 1
RIGBY, ID 83442
Jefferson County (208) 419-9383

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andrea Russell's NPI number?

The NPI number for Andrea Russell is 1104769520. It was assigned to this organization in the NPPES registry on April 10, 2026.

Where is Andrea Russell located?

Andrea Russell is located at 1200 Jaylee Dr Unit 1, Rigby, ID 83442. The listed phone number is (208) 419-9383.

What is Andrea Russell's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

When was this NPI record last updated?

The NPPES record for Andrea Russell was last updated on May 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.