Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominique Russell, MA, LCPC, LMHCTHLT

Individual provider Mental Health Counselor · NPI 1043980139

Dominique Russell, MA, LCPC, LMHCTHLT is a Mental Health Counselor in Chicago, Illinois. Practices as a sole proprietor and works from 2 locations. Licensed in Florida and Illinois.

Licensed in
FL, IL
In the registry since
2021
Specialties on file
2
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
LCPC — Licensed Clinical Professional Counselor
A licensed clinical counsellor.

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Practice location Address checks out

9200 S Emerald Ave
Chicago, IL 60620-2741
Phone: (904) 452-6725
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • Po Box 892, Interlachen, FL 32148-0892 — (904) 452-6725

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 180.016118 (IL)
Mental Health Counselor Taxonomy 101YM0800X · Licence TPMC5372 (FL)

Record details

NPI number1043980139
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , LCPC , LMHCTHLT
Sole proprietorYes
NPI enumeratedSeptember 20, 2021
Last updated in NPPESOctober 22, 2025
Certification dateOctober 22, 2025

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