Active NPI
Christina Russell, LICSW
- Mental Health Counselor
- Orleans, MA
National Provider Identifier
1558615534
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 117199
- Practice address
- 77 Finlay Rd
Orleans, MA 02653-3320 - Phone
- (781) 589-0143
- NPI assigned
- Oct 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 117199 | MA | Primary |
Addresses
Primary practice location
77 Finlay Rd
Orleans, MA 02653-3320
Mailing address
213 Hinckly Rd
Hyannis, MA 02601
Phone (781) 589-0143
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130125000180 | MA | Practitioner - Clinical Social Worker | 3375797400 | Practice locations: Harwich, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Boston University School of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
11 Lakewood Dr
Harwich, MA 02645-1804
Phone (781) 589-0143
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117199 | MA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351555200000",
"number": "1558615534",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "213 HINCKLY RD",
"city": "HYANNIS",
"state": "MA",
"postal_code": "02601",
"telephone_number": "781-589-0143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 FINLAY RD",
"city": "ORLEANS",
"state": "MA",
"postal_code": "026533320",
"telephone_number": "781-589-0143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "CHRISTINA",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-30",
"last_updated": "2012-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "117199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orleans, MA
- River View Counseling Consultants LLC
- Rock Harbor Health LLC (William M Velie MD Rock Harbor Health)
- Cindy Martha Rosenbaum, LICSW
- Marsha Ross, O.D.
- Edward M Ruscitti, D.C.
- Jason Ruttan, COTA
- Santos Complete Home Care, LLC
- Tracey Ann Schear, LCSW
- William James Scheier, DDS
- Alexander Joseph Shannon-Eckhardt, PHARMD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.