MS. JESSICA NICOLE JACK RUSSELL (NPI# 1184776692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184776692 |
| Entity Type | Individual |
| Full Name | MS. JESSICA NICOLE JACK RUSSELL |
| Credential | LISW |
| Practice Address |
425 Niles Cortland Rd Se Warren OH 44484-2478 |
| Mailing Address |
4206 Hopkins Rd Youngstown OH 44511-3710 |
| Practice Telephone | 3308563975 |
| Mailing Telephone | 4125594553 |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2019-11-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
I.1901879 | OH | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3 Kensington Sq, Suite B, New Kensington, PA 150686443 | 7243359733 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346859048 | Jessica Jane Russell | Behavior Technician | 1107 Carrie Bolin Dr, Columbia, KY 42728-1034 | 2020-07-28 |
| 1396192258 | Jessica Russell | Licensed Practical Nurse | 7712 Lake Ridge Dr, Waterford, MI 48327-4164 | 2016-05-20 |
| 1043693872 | Jessica Russell | Occupational Therapist | 302 Sadie Douglas Cir, Shreveport, LA 71106-7689 | 2015-06-29 |
| 1407120967 | Jessica Jean Russell | Massage Therapist | 219 S 4th St E, Missoula, MT 59801-2725 | 2012-03-01 |
| 1619103603 | Jessica Rylant Russell | Occupational Therapist | 4450 Landward Dr, Millbrook, AL 36054-2206 | 2009-06-03 |
| 1174121602 | Jessica Russell | Behavior Technician | 2288 Blue Water Blvd Ste 310, Odenton, MD 21113-3301 | 2020-10-16 |
| 1164049516 | Jessica Marie Russell | Physical Therapist | 2502 S Nc Highway 119, Mebane, NC 27302-9565 | 2020-07-01 |
| 1710521778 | Jessica Russell | Registered Nurse | 1199 Prince Ave, Athens, GA 30606-2797 | 2019-11-03 |
| 1821632100 | Jessica Russell | Student in an Organized Health Care Education/Training Program | 311 Whittington Ave, Hot Springs, AR 71901-3407 | 2019-10-30 |
| 1427605401 | Jessica Russell | Behavioral Analyst | 632 Eastern Blvd, Clarksville, IN 47129-2463 | 2019-08-23 |
| Street Address |
425 NILES CORTLAND RD SE |
| City | WARREN |
| State | OH |
| Zip Code | 44484-2478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154687390 | Preferred Care Associates, LLC | Counselor | 425 Niles Cortland Rd Se, Suite #201, Warren, OH 44484-2478 | 2012-04-02 |
| 1811101025 | Linda Ruth Myers | Marriage & Family Therapist | 425 Niles Cortland Rd Se, Suite 201, Warren, OH 44484-2478 | 2007-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205446283 | Jessica Toot | Behavior Technician | Oakwood Counseling Center LLC, 1704 North Road Se, Warren, OH 44484 | 2020-08-05 |
| 1558857060 | Quantina Louise Thomas | Home Health | 1548oak Knoll Se, Warren, OH 44484 | 2018-07-09 |
| 1033609706 | Justin A Houy | Massage Therapist | 8345 E. Market St. Suite C, The Chiropractic and Functional Neurology Center, Warren, OH 44484 | 2018-05-17 |
| 1679091359 | Ester Mae Butler | Nurse's Aide | 2228 Draper Avenue Se, Warren, OH 44484 | 2017-09-01 |
| 1477070811 | Amanda Lynn Heberling | Occupational Therapy Assistant | 8128 Kenyon Dr., Warren, OH 44484 | 2017-08-26 |
| 1790213650 | Joyce A Mechling | Licensed Practical Nurse | 2737 Youngstown Rd., Warren, OH 44484 | 2017-05-23 |
| 1598206898 | Stan Catullo | Substance Abuse Rehabilitation Facility | 2737 Youngstown Warren Road Se, Warren, OH 44484 | 2017-03-20 |
| 1679014054 | Pamela M Lang | Pharmacist | 1977 Niles Rd S.e., Genoa A Qol Healthcare Company, Warren, OH 44484 | 2017-03-17 |
| 1922454800 | Jeremy Michael Capetillo | Dentist | 8740 E Market St Ste 1, Warren, OH 44484 | 2016-05-10 |
| 1215311865 | Jessica Dawn Harris | Physical Therapy Assistant | 1926 Ridge Avenue, Warren, OH 44484 | 2015-07-14 |
| Find all providers in zip 44484 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679188924 | Amanda Rubio | Social Worker | 20 Brownell St, Warren, RI 02885-1525 | 2020-09-14 |
| 1265069082 | Tellecia Nasha Wiggins | Social Worker | 13807 Martin Rd, Warren, MI 48088-6325 | 2020-03-23 |
| 1528541984 | Undercurrent Behavioral Health LLC | Social Worker | 12500 E 13 Mile Rd, Warren, MI 48093-5011 | 2018-09-12 |
| 1770071201 | Tacara Lakaisha Woods | Social Worker | 23543 Bolam Ave, Warren, MI 48089-2232 | 2018-04-30 |
| 1730686197 | Lambro Seremetis | Social Worker | 12200 E. 12 Mile Road, Ste. 200, Warren, MI 48093 | 2018-04-11 |
| 1740790625 | Steven Potje | Social Worker | 7177 Miller Dr Ste C, Warren, MI 48092-1699 | 2017-10-05 |
| 1225554082 | Michigan Adult Services 1 | Social Worker | 28673 Hoover Rd, Warren, MI 48093-4105 | 2017-08-14 |
| 1437675220 | Rana Shaia | Social Worker | 12200 E 13 Mile Rd # 200, Warren, MI 48093-3093 | 2017-08-14 |
| 1982134052 | Connell Joseph Rooney | Social Worker | 8 Angus Ln, Warren, NJ 07059-6739 | 2017-06-12 |
| 1972030278 | Elizabeth Ann Oaks | Social Worker | 8600 E Market St Ste 8, Warren, OH 44484-2375 | 2017-05-17 |
| Find all providers in WARREN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.