Marissa Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

084759 Issued in NY

Practice address

3044 Route 50
Saratoga Springs, NY 12866-3073

Phone

(518) 886-5800

Fax

(518) 886-8505

NPI assigned

Jun 16, 2016

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

Other names 1

• Marissa R Capullo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1962852384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 ROUTE 50",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663073",
            "telephone_number": "518-886-5800",
            "fax_number": "518-886-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3044 ROUTE 50",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128663073",
            "telephone_number": "518-886-5800",
            "fax_number": "518-886-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "MARISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-16",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "084759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "CAPULLO",
            "middle_name": "R",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harriet Rubenstein, LCSW
• Christian Ruckert, DDS
• Rae Tieder Rudat, PT
• Cecilia P. Ruelos, M.D.
• Jennifer Runkel, PT
• Rustom a Rastinehad PC
• Kellen Ryan, PA
• Kathryn A. Sabo, PA-C
• Andreana Saffi Biasetti, R-LCSW
• Denise Marie Salage, LCSW

• Clinical Social Worker in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.