Russell Stewart Bryan, MSW, LCSW

Individual provider Active NPI Clinical Social Worker · New Albany, IN

NPI 1700568136 · NPPES record last updated Aug 4, 2023

Key facts

NPI
1700568136
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
34010095A (IN)
Practice address
2013 Locust St
New Albany, IN 47150-2772
Phone
(502) 939-8195
NPI assigned
Aug 4, 2023
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
34010095AINMDClinical Social Worker
6677KYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6677 KY
Clinical Social Worker 1041C0700X 34010095A IN Yes

Addresses

Primary practice location

2013 Locust St
New Albany, IN 47150-2772

Mailing address

2013 Locust St
New Albany, IN 47150-2772
Phone (502) 939-8195

Other providers in New Albany, IN

All providers in New Albany, IN · Clinical Social Worker in Indiana

Sources for this page

Verify at the official NPI Registry.