Bobbie Jean Russell, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

65453 Issued in TX

Practice address

1020 Byron LN
Arlington, TX 76012-1826

Phone

(214) 529-0622

NPI assigned

Feb 13, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2024 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1613174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613174400000",
    "number": "1972196616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BYRON LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760121826",
            "telephone_number": "214-529-0622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BYRON LN",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760121826",
            "telephone_number": "214-529-0622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BOBBIE",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-13",
        "last_updated": "2021-02-13",
        "certification_date": "2021-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Arlington",
            "affiliation": "N",
            "endpointDescription": "medical records",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1020 Byron Ln",
            "city": "Arlington",
            "state": "TX",
            "country_code": "US",
            "postal_code": "760121826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rush Creek Emergency Physicians PLLC
• Rushing Into Wellness
• Qiana Jeanette Rushing, LPC, MBA, M.A.R.C.
• Lori Russell-Siemer, LCSW
• Allison Marie Russell, ATC
• David Dee Russell, M.D.
• James Russell Jr., PHARMD
• Lauren Russell
• Stephen Beck Russell, RPH
• Rusty a. Mlhoan, MD PA

• Clinical Social Worker in Arlington, TX
• Providers in Arlington, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.