Healthcare Provider Details

I. General information

NPI: 1043503329
Provider Name (Legal Business Name): WINDY GAYLE RUSS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: WINDY GAYLE HALL LCSW

II. Dates (important events)

Enumeration Date: 05/19/2011
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N GREEN ST
HENDERSON KY
42420-2948
US

IV. Provider business mailing address

4600 MONTGOMERY RD STE 400
CINCINNATI OH
45212-2600
US

V. Phone/Fax

Practice location:
  • Phone: 833-510-4357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSWS991
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089830
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: