Nathanael William Russell, LMSW, QMHP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2837 Walnut St
Port Huron, MI 48060-2162

Phone

(810) 689-4547

NPI assigned

Apr 6, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Equity and Recovery Technologies LLCGroup PAC ID 3274022876, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Health Equity and Recovery Technologies LLC

  dba Heart

  • Clinical Social Worker
  • Shelby Township, MI
  • NPI 1952820060
  Medicare reassignment Care Compare group NPD
• Enlightened Mind LLC

  • Clinical Social Worker
  • Port Huron, MI
  • NPI 1912606997
  NPD Authorized official
• I Am-Wellness Group LLC

  • Clinical Social Worker
  • Shelby Township, MI
  • NPI 1518461532
  NPD (past)

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1093344681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 WALNUT ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602162",
            "telephone_number": "810-858-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 WALNUT ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602162",
            "telephone_number": "810-689-4547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "NATHANAEL",
        "middle_name": "WILLIAM",
        "credential": "LMSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801106998",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801114888",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanne Marie Royal-Kraut, LLMSW
• Kaiytlin Elaine Rumenapp, MA, LLPC
• Dianne Rumley
• Carissa J Rumps
• David Melvin Russeau
• Alexander Grant Ruthven II, MD
• Maureen M Ryan
• Adam M. Rybarczyk
• Krysta Marie Rybarczyk
• Anne Charlotte Ryle

• Clinical Social Worker in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2026; 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.