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SHONDREA RUSSUM PCMHT
NPI 1801332192
Counselor - Mental Health in Jackson, MS

Active since January 11, 2017
460 BRIARWOOD DR, SUITE 510, JACKSON, MS 39206(601) 956-4816(601) 956-4817 Get Directions Write a Review

NPPES record last updated: January 11, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shondrea Russum Pcmht NPPES

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

SHONDREA RUSSUM PCMHT (NPI 1801332192) is an individual mental health provider in Jackson, Mississippi, licensed in Mississippi (PH3926) and active in the NPI registry since January 2017.

NPPES Registry Identity

NPI1801332192
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameSHONDREA RUSSUMCredential: PCMHT
Location Address460 BRIARWOOD DR, SUITE 510Jackson, MS 39206-3051
Mailing Address460 Briarwood Dr, Suite 510Jackson, MS 39206-3051 · (601) 956-4816 · Fax (601) 956-4817
Phone(601) 956-4816
Fax(601) 956-4817
Sole ProprietorNo
Enumeration DateJanuary 11, 2017
✔ NPI 1801332192 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in MS · PH3926
460 BRIARWOOD DR, Jackson, MS 39206
Open in Google Maps ↗

Other Identifiers 1

Medicaid01670076MS

Other Providers at the Same Location NPPES 18

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

SEDRICK WILLIAMS
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
IAN JONES
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
TAMARIA BARNES CMHT
Social Worker (Clinical)
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
LAKEECHA JONES
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
PORTIA MOORE
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
WAVERLEY HEALTH CARE CONSULTANTS, INC.
Durable Medical Equipment & Medical Supplies (Parenteral & Enteral Nutrition)
460 BRIARWOOD DR, SUITE 410
JACKSON, MS 39206
Hinds County (601) 956-1576
SCHQUITA JONES
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816
DERRICK CAGINS
Case Manager/Care Coordinator
460 BRIARWOOD DR, SUITE 510
JACKSON, MS 39206
Hinds County (601) 956-4816

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 Shondrea Russum's NPI number?

The NPI number for Shondrea Russum is 1801332192. It was assigned to this individual provider in the NPPES registry on January 11, 2017.

Where is Shondrea Russum located?

Shondrea Russum practices at 460 Briarwood Dr Suite 510, Jackson, MS 39206. The listed phone number is (601) 956-4816.

What is Shondrea Russum's specialty?

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

When was this NPI record last updated?

The NPPES record for Shondrea Russum was last updated on January 11, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.