MS. BRANDY RUSSELL-MERVOSH (NPI# 1275504623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275504623 |
| Entity Type | Individual |
| Full Name | MS. BRANDY RUSSELL-MERVOSH |
| Credential | LCSW |
| Practice Address |
901 S Rogers St Bloomington IN 47403-4760 |
| Mailing Address |
Po Box 599 Spencer IN 47460-0599 |
| Practice Telephone | 8123239890 |
| Practice Fax Number | 8128292596 |
| Mailing Telephone | 8128292526 |
| Mailing Fax Number | 8128292596 |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2017-02-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
34002977A | IN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | BLUE SHIELD | 000000210144 | 01 |
| IN | CIGNA | 36295 | 01 |
| IN | AETNA | 7157432 | 01 |
| Street Address |
901 S ROGERS ST |
| City | BLOOMINGTON |
| State | IN |
| Zip Code | 47403-4760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518402163 | Caroline Hippler | Counselor | 901 S Rogers St, Suite 104, Bloomington, IN 47403-4756 | 2017-01-05 |
| 1942577572 | Cathleen Ingle Weber | Counselor | 901 S Rogers St, Suite 205, Bloomington, IN 47403-4756 | 2011-11-28 |
| 1700177003 | Parenting Plus, Inx | Community/Behavioral Health | 901 S Rogers St, Suite #103, Bloomington, IN 47403-4756 | 2011-04-21 |
| 1063652238 | Laura Petersen, M.s.w., L.c.s.w., L.L.C. | Social Worker | 901 S Rogers St, Suite 202, Bloomington, IN 47403-4756 | 2009-03-02 |
| 1518134097 | Gigi Pinnell Stowe | Psychologist | 901 S Rogers St, Suite 106, Bloomington, IN 47403-4756 | 2008-05-13 |
| 1639387590 | Angela R Marshall Psyd LLC | Psychologist | 901 S Rogers St, Suite 205, Bloomington, IN 47403-4756 | 2007-05-21 |
| 1154421295 | Angela R Marshall | Psychologist | 901 S Rogers St, Suite 205, Bloomington, IN 47403-4756 | 2006-09-25 |
| 1548203045 | Laura Petersen | Social Worker | 901 S Rogers St, Suite 202, Bloomington, IN 47403-4756 | 2006-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043783673 | Brook Whitaker | Registered Nurse | 4011 S. Monroe Medical Park Blvd, Bloomington, IN 47403 | 2019-01-07 |
| 1598251175 | Jacob Edward Lundorf | Nurse Practitioner | 2100 S Liberty Dr Ste B, Bloomington, IN 47403 | 2018-07-06 |
| 1568973717 | Gregory Thomas Dougan | Physician Assistant | 418 South Landmark Avenue, Bloomington, IN 47403 | 2017-10-16 |
| 1295276160 | Indiana Center for Recovery, LLC | Substance Abuse Rehabilitation Facility | 1004 W 1st Street, Bloomington, IN 47403 | 2017-03-13 |
| 1144694217 | Kayla Dewolf | Specialist/Technologist | 1471 W Allen St, Bloomington, IN 47403 | 2015-11-30 |
| 1164806444 | Monroe Hosoital | General Acute Care Hospital | 4011 Monroe Medical Park, Bloomington, IN 47403 | 2015-07-16 |
| 1821411588 | Jennifer Turner | Occupational Therapy Assistant | 1023 West Main St, Swiss Villa, Vevay, IN 47403 | 2014-01-30 |
| 1104170232 | Kendall Basore | Social Worker | 445 S. Landmark Ave., Bloomington, IN 47403 | 2012-10-26 |
| 1568715886 | Indiana Hearing LLC | Hearing Aid Equipment | 2019 S Liberty Dr, Bloomington, IN 47403 | 2012-10-24 |
| 1679870232 | Accurate Hearing Services | Clinic/Center | 1355 W Second St, #3, Bloomington, IN 47403 | 2011-02-17 |
| Find all providers in zip 47403 | ||||
| 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 |
|---|---|---|---|---|
| 1770101875 | Leah Elizabeth Sinn Iversen | Social Worker | 518 N Colony Ct, Bloomington, IN 47408-3012 | 2020-07-06 |
| 1972128825 | Elizabeth Heid Counseling Services LLC | Social Worker | 2103 E Washington St Bldg 1, Bloomington, IL 61701-4310 | 2020-06-16 |
| 1144845389 | Debra Diann Terfruchte | Social Worker | 2001 Withers Ln, Bloomington, IL 61704-9069 | 2020-06-13 |
| 1144857301 | Megan Stahly | Social Worker | 827 W 14th Ct, Bloomington, IN 47404-3347 | 2020-03-26 |
| 1659906634 | The Healing Tree Psychotherapy and Consulting Services, LLC | Social Worker | 2103 E Washington St Ste 2g, Bloomington, IL 61701-4365 | 2020-03-10 |
| 1972147429 | Nina Maria Castronova | Social Worker | 1886 E Cheyanne Ln, Bloomington, IN 47401-4143 | 2019-10-28 |
| 1942852488 | Kaitlin King, LLC. | Social Worker | 408 E. Dodds, Bloomington, IN 47401-4819 | 2019-07-15 |
| 1215400791 | Elizabeth Therese Heid | Social Worker | 2302 E Oakland Ave Ste 7, Bloomington, IL 61701-5875 | 2019-01-07 |
| 1689143232 | James Baugh | Social Worker | 1408 S Walnut St Ste A, Bloomington, IN 47401-5888 | 2018-11-13 |
| 1306344007 | Jillian Gonterman | Social Worker | 804 N College Ave, Bloomington, IN 47404-3526 | 2018-01-28 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 47403 |
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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.