Active NPI
Kimberly Russell
- Clinical Social Worker
- Washington, DC
National Provider Identifier
1205373693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LG50080706
- Practice address
- 7826 Eastern Ave NW
Suite 201
Washington, DC 20012-1324 - Phone
- (202) 285-6910
- NPI assigned
- Jan 24, 2017
- Sex
- Female
- Sole proprietor
- No
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 | LG50080706 | DC | Primary |
Addresses
Primary practice location
7826 Eastern Ave NW
Suite 201
Washington, DC 20012-1324
Mailing address
7826 Eastern Ave NW
Suite 201
Washington, DC 20012-1324
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 |
|---|---|---|---|
| LG50080706 | DC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1205373693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7826 EASTERN AVE NW",
"address_2": "SUITE 201",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200121324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7826 EASTERN AVE NW",
"address_2": "SUITE 201",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200121324",
"telephone_number": "202-285-6910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-24",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DC",
"license": "LG50080706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.