Active NPI
Gay Russell, LCSW
- Clinical Social Worker
- Bloomingdale, IL
National Provider Identifier
1013039502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149011209
- Practice address
- 148 S Bloomingdale Rd
Suite 112
Bloomingdale, IL 60108 - Phone
- (630) 894-4451
- Fax
- (630) 894-2876
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149011209 | IL | Primary |
Addresses
Primary practice location
148 S Bloomingdale Rd
Suite 112
Bloomingdale, IL 60108
Mailing address
904 S Roselle Road Unit 364
Schaumburg, IL 60193
Phone (847) 340-9297
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02221520 | Other | IL | BCBS |
Other names 1
- Gay McCallum
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149011209 | IL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feeling Whole Counseling Services Inc | Clinical | Current | Accepting new patients |
| Healthy Living International | Past | Accepting new patients |
Locations
904 S Roselle Rd
Schaumburg, IL 60193
Phone (847) 340-9297
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Schaumburg, IL
- NPI 1679789531
-
dba Bloomingdale Counseling Services
- Professional Counselor
- Bloomingdale, IL
- NPI 1518180892
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1013039502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 S ROSELLE ROAD UNIT 364",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "60193",
"telephone_number": "847-340-9297",
"fax_number": "847-985-1465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 S BLOOMINGDALE RD",
"address_2": "SUITE 112",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "60108",
"telephone_number": "630-894-4451",
"fax_number": "630-894-2876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "GAY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149011209",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "02221520",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GAY",
"last_name": "MCCALLUM",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.