Individual provider Active NPI

Qunesha Russell

  • Clinical Social Worker
  • Sebring, FL
National Provider Identifier
1780577445
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24835 Issued in FL
Practice address
1103 Scarab Dr
Sebring, FL 33872-2746
Phone
(863) 245-5724
Fax
(863) 245-5724
NPI assigned
Jun 2, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW24835 FL Primary

Addresses

Primary practice location

1103 Scarab Dr
Sebring, FL 33872-2746

Mailing address

1103 Scarab Dr
Sebring, FL 33872-2746
Phone (863) 245-5724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250715004165 FL Practitioner - Clinical Social Worker 1557876851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW24835FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Balanced Wellbeing LLC Clinical CurrentSince Jul 1, 2025 Accepting new patients

Locations

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

Networks

  • Freedom Health HMO Network

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": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1780577445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 SCARAB DR",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722746",
            "telephone_number": "863-245-5724",
            "fax_number": "863-245-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 SCARAB DR",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338722746",
            "telephone_number": "863-245-5724",
            "fax_number": "863-245-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "QUNESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebring, FL

Sources for this page

Verify at the official NPI Registry.