IndividualActive
Kelly Russell, PH.D.
NPI 1992179535 · Psychologist · Wyoming, MI
Provider details
- NPI number
- 1992179535
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 6301016993 (MI)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1055 Gezon Pkwy Sw
Wyoming, MI 49509-9542
Phone: (616) 773-2908
Fax: (616) 532-3046
Street-level locationGet directions
Mailing address
1055 Gezon Pkwy Sw
Wyoming, MI 49509-9542
Registry dates
- Enumerated
- 2015-11-19
- Last updated
- 2024-01-04
- Certified
- 2024-01-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.