Russell Salvatore Governale, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

044761 Issued in NY

Practice address

731 White Plains Rd
Bronx, NY 10473-2631

Phone

(718) 822-9140

NPI assigned

Jan 29, 2020

Sex

Male

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1295366268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MONTROSE AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112062043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104732631",
            "telephone_number": "718-822-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOVERNALE",
        "first_name": "RUSSELL",
        "middle_name": "SALVATORE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "044761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Gourgiotis
• Ella Gourley
• Afrodite Connie Gourtzelis
• Ivon Lestari Goutama, MD
• Mary Trace Gover, MD
• Denita Bernadette Govia, MHC
• Ramasamy Govindarajan, MD
• Gopal Govindraj, MD
• Teresa Gowan
• Vinayak Sreenivas Gowda, MD, MRCS,

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.