Gary Lee Russell, LPCC-S, LICDC
NPI 1003394180ActiveIndividual· Counselor, Mental Health· Mansfield, OH
Counselor, Mental Health (LPCC-S, LICDC) in Mansfield, Ohio, licensed in OH, with an NPI issued in August 2018. Enrolled in Medicare as practitioner - mental health counselor.
Overview
| NPI | 1003394180 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPCC-S, LICDC |
| Sole proprietor | Yes |
| NPI issued | Aug 1, 2018 |
| Last updated in NPPES | Feb 15, 2024 |
| Certified by provider | Feb 13, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Counselor, Mental Health Primary | 101YM0800X | E.2001844-SUPV | OH |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | LICDC.162577 | OH |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Mental Health Counselor (OH) |
|---|
Education and affiliations
| Graduation year | 2002 |
|---|---|
| Medicare specialty | Mental Health Counselor |
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