Olivia B Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008255A Issued in IN

Practice address

4735 Statesmen Dr Ste a
Indianapolis, IN 46250-5647

Phone

(317) 986-4956

Fax

(317) 452-8821

NPI assigned

Oct 3, 2018

Sex

Female

Sole proprietor

No

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

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.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Healing Bridges Counseling, LLC

  • Marriage & Family Therapist
  • Indianapolis, IN
  • NPI 1205313608

  Clinical

  NPD

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1083199251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 STATESMEN DR STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505647",
            "telephone_number": "317-986-4956",
            "fax_number": "317-452-8821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 STATESMEN DR STE A",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462505647",
            "telephone_number": "317-986-4956",
            "fax_number": "317-452-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "OLIVIA",
        "middle_name": "B",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008255A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Theresa Russell, NP
• Meghan Mary Russell
• Michael Russell, MD
• Michelle Lea Russell, RN
• Nathaniel Russell
• Rachel Russell, OTD,OTR
• Rachel Russell
• Rebecca Russell, LCSW
• Ronkisha L Russell, RBT
• Sarah Hermann Russell, PH.D.

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.