Healthcare Provider Details

I. General information

NPI: 1063918019
Provider Name (Legal Business Name): TERRI ANN RUSSELL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HENRICO COUNTY PUBLIC SCHOOLS 3820 NINE MILE RD.
HENRICO VA
23223
US

IV. Provider business mailing address

PO BOX 23120
RICHMOND VA
23223-0420
US

V. Phone/Fax

Practice location:
  • Phone: 804-343-6500
  • Fax:
Mailing address:
  • Phone: 804-343-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904004959
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: