DOMINIQUE RUSSELL MALCPC LMHC THLT NPI 1043980139

NPI Information

  • NPI: 1043980139
  • Provider Name: DOMINIQUE RUSSELL, MA,LCPC, LMHC THLT
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 9200 S EMERALD AVE
    CHICAGO, IL
    ZIP 60620
  • Phone: (904) 452-6725

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NPI Details

Dominique Russell, MA,LCPC, LMHC THLT is a professional counselor in Chicago, IL. Dominique Russell, MA,LCPC, LMHC THLT NPI is 1043980139. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9200 S EMERALD AVE
CHICAGO, IL
ZIP 60620-741
Phone: (904) 452-6725

The enumeration date for this NPI number is 9/20/2021 and was last updated on 3/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessionalTPMC5372FLORIDANo
2101YP2500XCounselorProfessional180.016118ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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