Valerie A Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14750 Issued in FL

Practice address

2800 N 6TH St # 752
St Augustine, FL 32084-1920

Phone

(917) 412-0664

NPI assigned

Jun 7, 2021

Last updated

Oct 28, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1295302594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 GARIBALDI WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N 6TH ST # 752",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320841920",
            "telephone_number": "917-412-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "VALERIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Rusich
• Ivory Russ
• Russell Denea, MD, LLC
• Caitlin Owen Russell
• Helena Russell, APRN
• Alexandra Russick, RBT
• Kristin Russo
• Alex Joseph Liboon Rustia, DMD
• RX-Mart Pharmacy LLC (Rx-Mart Pharmacy)
• Jake Ryan

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.