Individual
JINNA L RUSSELL
Active
Individual
JINNA L RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
14750
TX
101YP2500X
Professional Counselor
Primary
14750
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040802
MANAGED HEALTH NETWORK
—
01
—
1077155
CIGNA BEHAVIORAL HEALTH
—
01
—
136324
VALUE OPTIONS
—
01
—
222604
COMPSYCH
—
01
—
31623
AETNA
—
01
—
3708LC
BCBS
TX
01
—
6252509
UNITED BEHAVIORAL HEALTH
—
01
—
80115001
HEALTHSMART PPO
—
Enumeration date
08/21/2006
Last updated
11/16/2007
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