Andrea Russell
Andrea Russell is a healthcare organization registered as Community/Behavioral Health Agency in Rigby, ID, holding Type 2 (organization) NPI 1104769520 since 2026. The authorized official on file is Andrea Russell, Intervention Professional.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104769520 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Andrea Russell |
| Practice address | 1200 JAYLEE DR UNIT 1, Rigby, ID, 83442 |
| Phone | 2084199383 |
| Enumeration date | 2026-04-10 |
| Last updated in NPPES | 2026-05-13 |
Authorized official
| Name | Andrea Russell |
|---|---|
| Title | Intervention Professional |
| Phone | 2084199383 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | Secondary | — | — |
| 251S00000X | Community/Behavioral Health Agency | Primary | — | — |
Copy-ready billing details
Provider: Andrea Russell NPI: 1104769520 Taxonomy: 251S00000X (Community/Behavioral Health Agency) Address: 1200 JAYLEE DR UNIT 1, Rigby, ID, 83442
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1770342420 | Andrea Russell | Individual | Developmental Therapist | Rigby, ID |
Verify this record
Cross-check NPI 1104769520 against the authoritative CMS record: view Andrea Russell on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is a Type 2 NPI?
What type of organization is Andrea Russell?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2026-05-13.