Active NPI
Kalia Russell
- Social Worker
- Cleveland, OH
National Provider Identifier
1578242152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.2309607
- Practice address
- 22001 Fairmount Blvd
Cleveland, OH 44118-4897 - Phone
- (800) 879-2522
- NPI assigned
- Jul 12, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CDCA.186124 | OH | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | S.2309607 | OH | Primary |
Addresses
Primary practice location
22001 Fairmount Blvd
Cleveland, OH 44118-4897
Mailing address
22001 Fairmount Blvd
Cleveland, OH 44118-4897
Phone (800) 879-2522
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 |
|---|---|---|---|
| CDCA.186124 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| S.2309607 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697760000000",
"number": "1578242152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22001 FAIRMOUNT BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441184897",
"telephone_number": "800-879-2522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22001 FAIRMOUNT BLVD",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441184897",
"telephone_number": "800-879-2522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KALIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-12",
"last_updated": "2023-10-20",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "CDCA.186124",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.2309607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.