Individual provider Active NPI

Charman Russ, LLMSW

  • Clinical Social Worker
  • Muskegon, MI
National Provider Identifier
1528733276
Registry record updated Aug 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851110668 Issued in MI
Practice address
125 E Southern Ave Ste 100
Muskegon, MI 49442-5041
Phone
(231) 672-3582
NPI assigned
Aug 14, 2021
Last updated
Aug 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2021

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 6851110668 MI Primary

Addresses

Primary practice location

125 E Southern Ave Ste 100
Muskegon, MI 49442-5041

Mailing address

970 Williams St
Muskegon, MI 49442-3669
Phone (231) 728-9162

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6851110668MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1628899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628899200000",
    "number": "1528733276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 WILLIAMS ST",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494423669",
            "telephone_number": "231-728-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E SOUTHERN AVE STE 100",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425041",
            "telephone_number": "231-672-3582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "CHARMAN",
        "name_prefix": "Ms.",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-14",
        "last_updated": "2021-08-14",
        "certification_date": "2021-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851110668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2021; 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.