Shelly Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21305 Issued in TX

Practice address

5013 Westview Dr
Austin, TX 78731-4741

Phone

(512) 422-4389

Fax

(512) 453-2838

NPI assigned

Mar 26, 2012

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Shalom AustinGroup PAC ID 0749361921, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shelly.russell.1@33027.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shalom Austin

  • Clinical Social Worker
  • Austin, TX
  • NPI 1114466364
  Medicare reassignment Care Compare group NPD
• Jewish Community Association of Austin

  • Clinical Social Worker
  • Austin, TX
  • NPI 1003831892
  NPD
• PM Management - Cedar Park NC LLC

  • Skilled Nursing Facility
  • Cedar Park, TX
  • NPI 1548527963
  NPD (past)

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

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1043586860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5013 WESTVIEW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314741",
            "telephone_number": "512-422-4389",
            "fax_number": "512-453-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5013 WESTVIEW DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314741",
            "telephone_number": "512-422-4389",
            "fax_number": "512-453-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHELLY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "21305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Merrill Wiley Russell III, D.D.S.
• Michael Adam Russell, D.O.
• Millian Russell
• Peggy M Russell, D.O.
• Shannon Louise Russell, PT, DPT
• Sheryl Russell, LM, IBCLC
• Tamara Russell, M.A., CCC-SLP
• Tara Brynn Russell, LCSW
• Taylor Russell
• Taylor J Russell, BCBA

• Clinical Social Worker in Austin, TX
• Providers in Austin, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.