Alyssa L. Russell, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801095508 Issued in MI

Practice address

6425 S. Harvey St
Norton Shores, MI 49444-9739

Phone

(231) 737-3469

Fax

(231) 737-4548

NPI assigned

Jun 28, 2016

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

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.

• Cancer & Hematology Centers of Western Mi, P.C.

  • Community/Retail Pharmacy
  • Norton Shores, MI
  • NPI 1316197379
  NPD (past)

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1487005757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 FOREMOST DR SE STE 300",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467062",
            "telephone_number": "616-954-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S. HARVEY ST",
            "city": "NORTON SHORES",
            "state": "MI",
            "postal_code": "494449739",
            "telephone_number": "231-737-3469",
            "fax_number": "231-737-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ALYSSA",
        "middle_name": "L.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-28",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801095508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Ann Rodriguez
• Shelly M Rodriguez
• Eric C Rop, MD
• Dawn Vanessa Rozycki, LLPC
• Laura Rundell, LMT
• Diane Russick-Keglovitz, MA LLPC
• RX Optical Laboratories, Inc.
• Michael Thomas Rykse, D.C.
• Zabila Saeed, MD
• Safe Space Solutions of West Michigan

• Clinical Social Worker in Norton Shores, MI
• Providers in Norton Shores, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; 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.