Organization Active NPI

Lori Russell, LLC

  • Social Worker
  • Springfield, OR
National Provider Identifier
1497326409
Registry record updated Jul 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
LORI RUSSELL, LLC
Practice address
380 Q St
Springfield, OR 97477-2120
Phone
(541) 726-4118
NPI assigned
Jul 9, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2021

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

Authorized official

Name
Lori Ann Russell, LCSW, CADC IIINPI 1538331780
Title
Owner/Therapist
Phone
(541) 726-4118

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

380 Q St
Springfield, OR 97477-2120

Mailing address

PO Box 148
Springfield, OR 97477-0171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210707002592 OR Part B Supplier - Clinic/Group Practice 5597167965 Receives reassigned benefits from 1 practitioner
Practice locations: Cottage Grove, OR

National Provider Directory

National Provider Directory

Locations

609 E Main St
Cottage Grove, OR 97424
Phone (541) 726-4118

380 Q St
Springfield, OR 97477
Phone (541) 606-5954

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1497326409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 148",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974770171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 Q ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974772120",
            "telephone_number": "541-726-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI RUSSELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-09",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "541-726-4118",
        "authorized_official_credential": "LCSW, CADC III"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.