Monique Russell

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

099073 Issued in NY

Practice address

505 Hampton Park Blvd Ste Q
Capitol Heights, MD 20743-3862

Phone

(585) 333-0299

NPI assigned

Feb 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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 1

Specialty

Clinical Social Worker

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willow Oak Community Behavioral Health Center

  dba Willow Oak Center

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1881131860
  Medicare reassignment NPD
• Olivias Friends Care Management Agency LLC

  • Case Management Agency
  • Malverne, NY
  • NPI 1730781758
  NPD (past) Authorized official
• Willow Oak Foundation, Inc.

  • Community/Behavioral Health Agency
  • Newnan, GA
  • NPI 1588273528
  NPD (past)

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

{
    "created_epoch": "1519776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1437650025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST UNIT 516",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302133605",
            "telephone_number": "585-333-0299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 HAMPTON PARK BLVD STE Q",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207433862",
            "telephone_number": "585-333-0299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5240 Merrick Rd",
            "address_purpose": "LOCATION",
            "city": "Massapequa",
            "state": "NY",
            "postal_code": "117586207",
            "country_code": "US",
            "telephone_number": "516-590-7335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MONIQUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-28",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009661",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "109638",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29801",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saraiya Noelle Robinson
• Synethia Robinson, HHA
• Tammi Rolle, MA, CCC-SLP
• Kennon Lashawn Ross
• Marion Rudasill, PT
• S and C United Care Services Inc
• Stephanie Salamone
• Isaiah Samuels
• Saffiatu Sankoh
• Saving Lives Center LLC

• Clinical Social Worker in Capitol Heights, MD
• Providers in Capitol Heights, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.