Mark H Russ, LCSWC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

1180 Professional CT
Hagerstown, MD 21740-5852

Phone

(301) 791-3045

Fax

(240) 313-3071

NPI assigned

Jul 26, 2023

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

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Mental Health Center of Western Maryland, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Hagerstown, MD
  • NPI 1104871946

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1679254460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405852",
            "telephone_number": "301-791-3045",
            "fax_number": "240-313-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 PROFESSIONAL CT",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217405852",
            "telephone_number": "301-791-3045",
            "fax_number": "240-313-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSS",
        "first_name": "MARK",
        "middle_name": "H",
        "credential": "LCSWC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-26",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Jay Rubino, DDS
• Tara Ann Rumbarger, M.D.
• Patricia A Runkles, PT
• Courtney Lavone Rush
• Julie Lynn Rush, LCSW-C
• Zsanee Russell
• David Michael Russo, P.D.
• Lydia Russo, CRNA
• David Forrest Rutherford, LCSWC MSSW
• Amber Rutkowski, CRNP

• Clinical Social Worker in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.