KELLY GRAVINO RUSSELL (NPI# 1336244763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336244763 |
| Entity Type | Individual |
| Full Name | KELLY GRAVINO RUSSELL |
| Credential | LICSW |
| Practice Address |
16 Bush Hill Rd Ipswich MA 01938-1642 |
| Practice Telephone | 9788108397 |
| Mailing Telephone | 9788108397 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2020-06-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
110340 | MA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326468729 | Kelly Russell | Counselor | 3415 Se Powell Blvd Trillium Family Services, Portland, OR 97202 | 2014-04-24 |
| 1376829838 | Kelly C Russell | Counselor | 24 Pleasant St Rear, Newburyport, MA 01950-2610 | 2011-10-28 |
| 1154957652 | Kelly Russell | Advanced Practice Midwife | 101 Dudley St, Providence, RI 02905-2401 | 2020-03-16 |
| 1942770409 | Kelly Leonora Russell | Counselor | 611 12th Ave S, Seattle, WA 98144-2007 | 2018-11-27 |
| 1992179535 | Kelly Marie Spegel Russell | Psychologist | 1843 Rw Berends Dr Sw, Wyoming, MI 49519-4955 | 2015-11-19 |
| 1346591898 | Kelly Hanh Russell | Physician Assistant | 1375 N 10th Ave, Stayton, OR 97383 | 2012-09-24 |
| 1538375233 | Kelly Shannon Russell | Nurse Practitioner | 200 N Easton, Allen, OK 74825-9713 | 2007-05-16 |
| 1205816923 | Kelly Yvette Russell | Anesthesiology | 1850 N Central Ave, Ste1600, Phoenix, AZ 85004-4527 | 2006-01-19 |
| Street Address |
16 BUSH HILL RD |
| City | IPSWICH |
| State | MA |
| Zip Code | 01938-1642 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609306786 | Richard Scott Russell | Social Worker | 16 Bush Hill Rd, Ipswich, MA 01938-1642 | 2017-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019446 | Appleton Eye Associates PC | Optometrist | 21 Market Street, Suite 100, Ipswitch, MA 01938 | 2020-10-08 |
| 1093297442 | Geraldine E Gomery | Social Worker | 6 Stage Hill Road, Ipswich, MA 01938 | 2018-09-02 |
| 1336665041 | Kristen Caggiano | Physical Therapist | 73 Turnpike Rd, Unit 1a Bldgc, Ipswich, MA 01938 | 2017-08-15 |
| 1437548948 | Shabana Mohamed | Social Worker | Lahey Health Primary Care, Ipswich, 36 Essex Road, Ipswich, MA 01938 | 2015-01-21 |
| 1700281771 | Brian Calandra | Physical Therapist | 3 Dix Rd, Ipswich, MA 01938 | 2014-11-03 |
| 1023237153 | Michael P Arsenault | Acupuncturist | Internal Arts Acupuncture, 77 Turnpike Road - Rt. #1, Ipswich, MA 01938 | 2007-04-25 |
| 1629123542 | Jane M Woodman | Clinical Nurse Specialist | Appleton Building 2 No Main St Suite 3, Ipswich, MA 01938 | 2007-01-23 |
| 1417043118 | Paul S. Scioli | Chiropractor | 130 County Rd., Suite L., Ipswich, MA 01938 | 2006-10-04 |
| 1821181561 | Rita V Kelleher | Occupational Therapist | 30 Jeffrey's Neck Road, Ipswich, MA 01938 | 2006-10-02 |
| 1619956794 | Lisa Ann Traveis | Optometrist | 21 Market Street, Ste. 100, Ipswich, MA 01938 | 2006-01-17 |
| Find all providers in zip 01938 | ||||
| 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 |
|---|---|---|---|---|
| 1962013235 | Corf Psychology Group LLC | Social Worker | 4 S Main St Ste 9, Ipswich, MA 01938-2345 | 2020-08-11 |
| 1265903611 | Shelley Washitz | Social Worker | 174 County Rd, Ipswich, MA 01938-2721 | 2018-12-11 |
| 1629553367 | John Lichten | Social Worker | 7 Waldingfield Rd, Ipswich, MA 01938-2732 | 2018-09-28 |
| 1902389620 | Cheryl Ann Ferris | Social Worker | 1 Blaisdell Ter, Ipswich, MA 01938-1706 | 2018-09-09 |
| 1093297442 | Geraldine E Gomery | Social Worker | 6 Stage Hill Road, Ipswich, MA 01938 | 2018-09-02 |
| 1437548948 | Shabana Mohamed | Social Worker | Lahey Health Primary Care, Ipswich, 36 Essex Road, Ipswich, MA 01938 | 2015-01-21 |
| 1831465418 | Jan Pieter Struyde | Social Worker | 2 Edge St, Ipswich, MA 01938-1110 | 2012-03-28 |
| 1205920824 | Carrie L Stoner | Social Worker | 25r Market Street, Ipswich, MA 01938-2211 | 2006-10-03 |
| 1841303237 | Kim A. Collins | Social Worker | 25r Market St, Ipswich, MA 01938-2211 | 2006-08-17 |
| 1609306786 | Richard Scott Russell | Social Worker | 16 Bush Hill Rd, Ipswich, MA 01938-1642 | 2017-06-12 |
| Find all providers in IPSWICH | ||||
Please comment or provide details below to improve the information on KELLY GRAVINO RUSSELL.
| 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.