Active NPI
Ralph J Russell, LCSW
- Clinical Social Worker
- Harlem, MT
National Provider Identifier
1649394008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 175 LCSW
- Practice address
- RR 1 Box 67
Harlem, MT 59526-9705 - Phone
- (406) 353-3100
- Fax
- (406) 353-3229
- NPI assigned
- Mar 19, 2007
- Last updated
- Feb 1, 2008
- Sex
- Male
- 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 | 175 LCSW | MT | Primary |
Addresses
Primary practice location
RR 1 Box 67
Harlem, MT 59526-9705
Mailing address
319 9TH Ave
Havre, MT 59501-3754
Phone (406) 353-3162
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175 LCSW | Other | MT | LICENSE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175 LCSW | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1649394008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "319 9TH AVE",
"city": "HAVRE",
"state": "MT",
"postal_code": "595013754",
"telephone_number": "406-353-3162",
"fax_number": "406-353-3308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 1 BOX 67",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269705",
"telephone_number": "406-353-3100",
"fax_number": "406-353-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "RALPH",
"middle_name": "J",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-19",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "175 LCSW",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "175 LCSW",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlem, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.