Active NPI
Teresa Marie Antonette Russell, L.C.S.W.
- Clinical Social Worker
- Busby, MT
National Provider Identifier
1780847616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 824
- Practice address
- 29 417 E Hyw 212
Busby, MT 59016-0201 - Phone
- (406) 592-3515
- NPI assigned
- Jul 10, 2008
- Last updated
- Oct 26, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 824 | MT | Primary |
Addresses
Primary practice location
29 417 E Hyw 212
Busby, MT 59016-0201
Mailing address
PO Box 201
Busby, MT 59016-0201
Phone (406) 592-3515
Other names 1
- Maria Russell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1780847616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 201",
"city": "BUSBY",
"state": "MT",
"postal_code": "590160201",
"telephone_number": "406-592-3515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 417 E HYW 212",
"city": "BUSBY",
"state": "MT",
"postal_code": "590160201",
"telephone_number": "406-592-3515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "TERESA",
"middle_name": "MARIE ANTONETTE",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-10",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARIA",
"last_name": "RUSSELL",
"credential": "L.C.S.W.",
"code": "5",
"type": "Other Name"
}
]
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.