Individual provider Active NPI

Melanie Russell, MSW,LCSW

  • Clinical Social Worker
  • Anna, IL
National Provider Identifier
1487528055
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.029169 Issued in IL
Practice address
800 N Main St
Anna, IL 62906-1665
Phone
(618) 833-4456
Fax
(618) 833-2371
NPI assigned
Oct 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.029169 IL Primary

Addresses

Primary practice location

800 N Main St
Anna, IL 62906-1665

Mailing address

902 W Main St
West Frankfort, IL 62896-2210
Phone (618) 326-2772

Other names 1

  • Melanie Morrison Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20251018000356 IL Practitioner - Clinical Social Worker 9335637768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

902 W Main St
West Frankfort, IL 62896-2210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.029169ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Illinois, Inc CurrentSince Sep 29, 2025 Accepting new patients
Centerstone of Illinois, Inc CurrentSince Sep 29, 2025 Accepting new patients

Locations

800 N Main St
Anna, IL 62906
Phone (618) 833-4456

902 W Main St
West Frankfort, IL 62896
Phone 6189376483 ext. 7565

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1759708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1487528055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-326-2772",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061665",
            "telephone_number": "618-833-4456",
            "fax_number": "618-833-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MELANIE",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.029169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELANIE",
            "last_name": "MORRISON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anna, IL

Sources for this page

Verify at the official NPI Registry.