Active NPI
Michal Herridge Rusk, LCSW MSW BA
- Clinical Social Worker
- Riverhead, NY
National Provider Identifier
1265567010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R 0564041
- Practice address
- 223 Roanoak Ave
Riverhead, NY 11901 - Phone
- (631) 727-9255
- Fax
- (631) 727-9255
- NPI assigned
- Feb 22, 2007
- 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 | R 0564041 | NY | Primary |
Addresses
Primary practice location
223 Roanoak Ave
Riverhead, NY 11901
Mailing address
223 Roanoak Ave
Riverhead, NY 11901
Phone (631) 727-9255
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
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 0564041 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265567010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223 ROANOAK AVE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "11901",
"telephone_number": "631-727-9255",
"fax_number": "631-727-9255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "223 ROANOAK AVE",
"city": "RIVERHEAD",
"state": "NY",
"postal_code": "11901",
"telephone_number": "631-727-9255",
"fax_number": "631-727-9255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSK",
"first_name": "MICHAL",
"middle_name": "HERRIDGE",
"name_prefix": "Mrs.",
"credential": "LCSW MSW BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R 0564041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverhead, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.