Kelly G Russell, LICSW
Social Worker, Clinical in Ipswich, Massachusetts
1336244763- Practice location
- 16 Bush Hill RD, Ipswich, MA 01938-1642
- Phone
- 978-810-8397
- Fax
- —
- Last updated
- June 29, 2020
Kelly Gravino Russell is a Social Worker, Clinical based in Ipswich, MA. Kelly Gravino Russell practices in Ipswich, MA and has the professional credentials of LICSW. The NPI Number for Kelly Gravino Russell is 1336244763 and holds a License No. 110340 (MA). The current practice location address for Kelly Gravino Russell is 16 Bush Hill RD, Ipswich, MA 01938-1642 and can be reached out via phone at 978-810-8397.
Provider Profile Details
- NPI Number
- 1336244763
- Provider Name
- Kelly Gravino Russell
- Credential
- LICSW
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 16 Bush Hill RD, Ipswich, MA 01938-1642
- Phone Number
- 978-810-8397
- Primary Taxonomy
- Social Worker, Clinical · 1041C0700X
- Sole Proprietor
- Yes
- Provider Enumeration Date
- September 13, 2006
- Last Update Date
- June 29, 2020
- Certification Date
- June 29, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 16 Bush Hill RD
Ipswich, MA 01938-1642 - City
- Ipswich
- State
- Massachusetts
- Zip
- 01938-1642
- Phone Number
- 978-810-8397
Provider Business Mailing Address Details
- Address
- 16 Bush Hill RD
Ipswich, MA 01938-1642 - City
- Ipswich
- State
- MA
- Zip
- 01938-1642
- Phone Number
- 978-810-8397
License Information
- License Number
- 110340
- License State
- MA
- Taxonomy
- Social Worker, Clinical · 1041C0700X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kelly G Russell, LICSW?
The NPI number of Kelly G Russell, LICSW is 1336244763. It was assigned on September 13, 2006 and is currently active in the NPPES registry.
What is the specialty of Kelly G Russell, LICSW?
Kelly G Russell, LICSW is registered under the primary taxonomy Social Worker, Clinical (code 1041C0700X), licensed in MA under license number 110340.
Where does Kelly G Russell, LICSW practice?
The practice location is 16 Bush Hill RD, Ipswich, MA 01938-1642. The office can be reached at 978-810-8397 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1336244763 directly on the NPPES registry website.