Active NPI
Dorothy Nicole Russell, LCSW-C
- Clinical Social Worker
- Middletown, DE
National Provider Identifier
1700587029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- Q1-0012164
- Practice address
- 507 S Broad St
Middletown, DE 19709-1464 - Phone
- (440) 865-0975
- NPI assigned
- Mar 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 24640 | MD | |
| Clinical Social Worker | 1041C0700X | Q1-0012164 | DE | Primary |
Addresses
Primary practice location
507 S Broad St
Middletown, DE 19709-1464
Mailing address
507 S Broad St
Middletown, DE 19709-1464
Other practice location 1
314 Grove Neck Rd
Earleville, MD 21919-3008
Phone (410) 275-6285
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24640 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrive Counseling LLC | Current | Accepting new patients |
Locations
1326 S Governors Ave
Ste A
Dover, DE 19904
Phone (302) 246-5527
1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689206400000",
"number": "1700587029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 S BROAD ST",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197091464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 S BROAD ST",
"city": "MIDDLETOWN",
"state": "DE",
"postal_code": "197091464",
"telephone_number": "440-865-0975"
}
],
"practiceLocations": [
{
"address_1": "314 Grove Neck Rd",
"address_purpose": "LOCATION",
"city": "Earleville",
"state": "MD",
"postal_code": "219193008",
"country_code": "US",
"telephone_number": "410-275-6285",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSELL",
"first_name": "DOROTHY",
"middle_name": "NICOLE",
"credential": "LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-14",
"last_updated": "2023-07-13",
"certification_date": "2023-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "24640",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "DE",
"license": "Q1-0012164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middletown, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.