Larry Wayne Russell, LSW MA

Primary specialty

Social WorkerTaxonomy code 104100000X

License

AP00940954 Issued in WV

Practice address

70 Parcoal Rd
Webster Springs, WV 26288-9767

Phone

(304) 847-5425

Fax

(304) 847-5422

NPI assigned

Sep 25, 2006

Last updated

Aug 8, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218153600000",
    "number": "1588765614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 FRONT ST",
            "city": "RICHWOOD",
            "state": "WV",
            "postal_code": "262611307",
            "telephone_number": "304-847-5425",
            "fax_number": "304-847-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 PARCOAL RD",
            "city": "WEBSTER SPRINGS",
            "state": "WV",
            "postal_code": "262889767",
            "telephone_number": "304-847-5425",
            "fax_number": "304-847-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "LARRY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LSW MA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WV",
            "license": "AP00940954",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810000479",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mansoor A. Raja, MD
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• Jody Rose
• Cheryl Rumney
• Terry Gene Sanders II, M.D.
• Angela Schrader
• Cathy Ann Schrader, MA
• Jennifer Dawn Schrader
• Kevin Schrader

• Social Worker in Webster Springs, WV
• Providers in Webster Springs, WV by specialty
• Social Worker in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.