Individual provider Active NPI

Russell Chidinma Claver-Obinna, LPC, LCPC

  • Professional Counselor
  • Rockville, MD
National Provider Identifier
1275217408
Registry record updated Apr 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC14290 Issued in MD
Practice address
50 W Montgomery Ave Ste 300
Rockville, MD 20850-4244
Phone
(240) 686-5390
NPI assigned
Jun 8, 2023
Last updated
Apr 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 006081 CT
Professional Counselor 101YP2500X LC14290 MD Primary

Addresses

Primary practice location

50 W Montgomery Ave Ste 300
Rockville, MD 20850-4244

Mailing address

50 W Montgomery Ave Ste 300
Rockville, MD 20850-4244
Phone (240) 686-5390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20241119002163 DC Practitioner - Mental Health Counselor 4385179050 Reassigns benefits to 1 organization
I20241119003455 MD Practitioner - Mental Health Counselor 4385179050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Services, IncGroup PAC ID 2264424282, 9 clinicians

Practice addresses (Care Compare)

610 E Diamond Ave
Suite 100
Gaithersburg, MD 20877-5321
Phone (301) 840-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006081CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Way Station, Inc. Current Accepting new patients
Venus & Mars Psychotherapy, L.L.C. CurrentSince Dec 10, 2023 Accepting new patients
Mosaic Community Services, Inc. Current Accepting new patients
Harmony Holistic LLC CurrentSince Dec 10, 2023 Accepting new patients
Family Services, Inc Current Accepting new patients
Family Services, Inc. CurrentSince Oct 31, 2024 Accepting new patients

Locations

2225 N Charles St
Baltimore, MD 21218
Phone (410) 366-4360

610 E Diamond Ave
Ste 100
Gaithersburg, MD 20877
Phone (301) 840-2000

328 N Potomac St
Hagerstown, MD 21740
Phone (410) 740-1901

50 W Montgomery Ave
Ste 300
Rockville, MD 20850
Phone (240) 686-5390

1925 Greenspring Dr
Timonium, MD 21093

288 E Green St
Westminster, MD 21157
Phone (410) 751-5970

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713139200000",
    "number": "1275217408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504244",
            "telephone_number": "240-686-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W MONTGOMERY AVE STE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504244",
            "telephone_number": "240-686-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAVER-OBINNA",
        "first_name": "RUSSELL",
        "middle_name": "CHIDINMA",
        "name_prefix": "Mr.",
        "credential": "LPC, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-08",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "006081",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.