Active NPI
Lolamae Russell
- Clinical Social Worker
- Baltimore, MD
National Provider Identifier
1558787184
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17189
- Practice address
- 2910 Andorra CT Apt F
Baltimore, MD 21234-4326 - Phone
- (410) 948-8018
- NPI assigned
- Mar 6, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17189 | MD | Primary |
Addresses
Primary practice location
2910 Andorra CT Apt F
Baltimore, MD 21234-4326
Mailing address
11550 Crossroads Cir Unit 340
Middle River, MD 21220-2967
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17189 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550534400000",
"number": "1558787184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11550 CROSSROADS CIR UNIT 340",
"city": "MIDDLE RIVER",
"state": "MD",
"postal_code": "212202967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 ANDORRA CT APT F",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212344326",
"telephone_number": "410-948-8018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "LOLAMAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-06",
"last_updated": "2019-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "17189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.