Andrea Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255251 Issued in KY

Practice address

1436 S Shelby St
Louisville, KY 40217-1195

Phone

(502) 636-0771

NPI assigned

Aug 2, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Andrea Jones Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612396800000",
    "number": "1124306576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1436 S SHELBY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171107",
            "telephone_number": "502-636-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 S SHELBY ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171195",
            "telephone_number": "502-636-0771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Preston St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021716",
            "country_code": "US",
            "telephone_number": "502-589-8600 x1275",
            "fax_number": "502-589-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ANDREA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "JONES",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Heather Marie Rush, APRN
• Emily Rusher, OTR/L
• Eric U Russ, PH.D.
• Jacqueline Blake Russ, APRN
• Amy Russell, OTR/L
• Clement Street Russell, PSY.D.
• Cynthia J Russell, ARNP
• Donna Marie Russell, LCSW
• Dorothy K Russell, ATR-BC
• Greg Russell, RPH

• Clinical Social Worker in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.