Camethia Pashell Russell, LCSW, MPH, MHA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C015186 Issued in NC

Practice address

BLDG D-3145 Mederet Street
Fort Bragg, NC 28310-0001

Phone

(910) 432-1464

NPI assigned

Aug 11, 2022

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1720716228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107394",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG D-3145 MEDERET STREET",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-432-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CAMETHIA",
        "middle_name": "PASHELL",
        "credential": "LCSW, MPH, MHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C015186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Petural Ruffin Polk, R.N.
• Micah Rugenstein, PA
• Gregory Rummel, MD
• Rachelle Rush, OTR/L
• Reagan M. Ruska, AUD
• Gloria Elizabeth Russell, FNP-C
• Thomas Rutledge, PHD
• Douglas Robert Ryan, PA-C
• Emily M Ryan
• Sarah R Ryan, AT, ATC

• Clinical Social Worker in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; 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.