Active NPI
Deborah Russ, LCSW MAC
- Clinical Social Worker
- Soldotna, AK
National Provider Identifier
1154028173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 191463
- Practice address
- 35831 Turnbuckle Terrace Rd
Soldotna, AK 99669-6737 - Phone
- (907) 398-2396
- Fax
- (907) 891-7873
- NPI assigned
- Feb 9, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 191463 | AK | Primary |
Addresses
Primary practice location
35831 Turnbuckle Terrace Rd
Soldotna, AK 99669-6737
Mailing address
PO Box 8501
Nikiski, AK 99635-8501
Phone (907) 398-2396
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 191463 | AK | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675900800000",
"number": "1154028173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8501",
"city": "NIKISKI",
"state": "AK",
"postal_code": "996358501",
"telephone_number": "907-398-2396",
"fax_number": "907-891-7873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35831 TURNBUCKLE TERRACE RD",
"city": "SOLDOTNA",
"state": "AK",
"postal_code": "996696737",
"telephone_number": "907-398-2396",
"fax_number": "907-891-7873"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSS",
"first_name": "DEBORAH",
"credential": "LCSW MAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-02-09",
"last_updated": "2023-02-09",
"certification_date": "2023-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AK",
"license": "191463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Soldotna, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.