MEDICARE: JUAN MIGUEL RUSSIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	91083	TX

General Provider Information

NPI Number	:	1588528186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN MIGUEL RUSSIAN

Provider Business Mailing Address
First Line	:	1870 RUFE SNOW DR
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-5629
Country	:	US
Telephone Number	:	903-780-6097
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 LONG PRAIRIE RD STE A
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4958
Country	:	US
Telephone Number	:	903-780-6097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

Similar Medicare Providers

1710328919 — COURTNEY M. ENGLAND M.S., LPC
Practice Location Address:

3204 LONG PRAIRIE RD STE A-1
FLOWER MOUND, TX
75022-4958

Practice Phone: 469-322-1470
Practice Fax:

1093430787 — MEAGAN RENAE THOMAS LCSW
Practice Location Address:

3204 LONG PRAIRIE RD STE A
FLOWER MOUND, TX
75022-4958

Practice Phone: 940-613-1436
Practice Fax:

1225184567 — MRS. KAYLENE DENISE WARNER LCSW
Practice Location Address:

1011 SURREY LN STE 18
FLOWER MOUND, TX
75022-4211

Practice Phone: 214-646-3236
Practice Fax:

1760346456 — MADELINE ELAINE MCCULLOCH
Practice Location Address:

3305 LONG PRAIRIE RD STE 105
FLOWER MOUND, TX
75022-2775

Practice Phone: 469-699-4931
Practice Fax:

1780491944 — SAHVANNAH GONZALEZ APRN
Practice Location Address:

2960 LONG PRAIRIE RD
FLOWER MOUND, TX
75022-4845

Practice Phone: 972-333-5760
Practice Fax: 972-797-9224

1669180402 — FOLASHADE WILLIAMS LMFT-A
Practice Location Address:

777 INTERNATIONAL PKWY STE 260
FLOWER MOUND, TX
75022-5303

Practice Phone: 972-221-7900
Practice Fax:

Directions to “ JUAN MIGUEL RUSSIAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.