Ceirra Alise Russell, LLMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801094383 Issued in MI

Practice address

610 S Burdick St
Kalamazoo, MI 49007-5221

Phone

(269) 381-3700

Fax

(269) 381-3810

NPI assigned

Jan 3, 2013

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": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1487991972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S BURDICK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075221",
            "telephone_number": "269-381-3700",
            "fax_number": "269-381-3810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CEIRRA",
        "middle_name": "ALISE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Rupp III, DDS
• Matthew G Rushlau, ED.D.
• Loren L Russcher, MD
• Jared Russel, BT
• Andrew John Russell, MD
• Luke Raymond Russell, DO
• Nicole Russell
• Patricia Ann Russell, RN
• Rebecca Linnea Russell, MD
• Renee Nicole Russo, MA, LPC

• Clinical Social Worker in Kalamazoo, MI
• Providers in Kalamazoo, 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 Jan 3, 2013; 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.