Christina Rachelle Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW018168 Issued in PA

Practice address

7116 Clinton Rd Ste a
Upper Darby, PA 19082-5212

Phone

(856) 629-0464

NPI assigned

Jan 25, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: christina.russell.2@33040.direct.athenahealth.com

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.

• Holistic Therapy Services

  • Community/Behavioral Health Agency
  • Upper Darby, PA
  • NPI 1790317659
  NPD Authorized official

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

{
    "created_epoch": "1579910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1700416005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7116 CLINTON RD STE A",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190825212",
            "telephone_number": "856-629-0464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7116 CLINTON RD STE A",
            "city": "UPPER DARBY",
            "state": "PA",
            "postal_code": "190825212",
            "telephone_number": "856-629-0464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CHRISTINA",
        "middle_name": "RACHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-25",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06041600",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q5-0000112",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teikeita Maria Rollerson
• Roy R Kinder Jr MD PC
• Royal Homecare and Community Services
• Royal Medical Services LLC
• Royal Special Care LLC
• Tarnyenoh Sackor
• Nadya Saeed
• Safeguard Transportation LLC
• Salud Optima Direct, PLLC
• Dammy Sanou-Adekanmbi

• Clinical Social Worker in Upper Darby, PA
• Providers in Upper Darby, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2024; 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.