MEDICARE: MR. WILLIAM E. RUSSELL L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	0904000186	VA

General Provider Information

NPI Number	:	1013000520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM E. RUSSELL L.C.S.W.

Provider Business Mailing Address
First Line	:	3322 GROVE AVENUE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23221-2818
Country	:	US
Telephone Number	:	804-257-5923
Fax Number	:

Provider Business Practice Location Address
First Line	:	3322 GROVE AVENUE
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23221-2818
Country	:	US
Telephone Number	:	804-257-5923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	04/12/2026

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