Provider Demographics
NPI:1962297804
Name:RUSSELL, ALISON HUNDT (MED, LMHC)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:HUNDT
Last Name:RUSSELL
Suffix:
Gender:
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10808 COURAGEOUS DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-9570
Mailing Address - Country:US
Mailing Address - Phone:317-532-7295
Mailing Address - Fax:
Practice Address - Street 1:10808 COURAGEOUS DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-9570
Practice Address - Country:US
Practice Address - Phone:317-532-7295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004934A101Y00000X, 101YP2500X, 171M00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator