Kristen Jane Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008396 Issued in NC

Practice address

2608 Erwin Rd
300
Durham, NC 27705-4596

Phone

(919) 385-3232

NPI assigned

Apr 24, 2017

Last updated

Mar 16, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1013442474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 BROAD ST # 300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054833",
            "telephone_number": "703-606-0232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 ERWIN RD",
            "address_2": "300",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054596",
            "telephone_number": "919-385-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "KRISTEN",
        "middle_name": "JANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Russell-Gillette, MD
• Allison Russell, OTR/L
• Darius Lamont Russell, PHARM.D.
• Gina Russell
• Hilary Lynn Russell, PA
• Madeline Marie Russell
• Scotti Russell
• Shannon Griffin Russell, RDN, LDN
• Shawnesi Russell, CD(DONA)
• Zoe Russell

• Clinical Social Worker in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.

Verify at the official NPI Registry.