MEDICARE: MISS CLAUDIA E RUSSELL LCSW

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	SW8389	FL

General Provider Information

NPI Number	:	1578768651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CLAUDIA E RUSSELL LCSW

Provider Business Mailing Address
First Line	:	PO BOX 8362
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-0362
Country	:	US
Telephone Number	:	561-900-4662
Fax Number	:	561-257-1231

Provider Business Practice Location Address
First Line	:	1710 E TIFFANY DR STE 321
Second Line	:
City	:	MANGONIA PARK
State	:	FL
Zip	:	33407-3242
Country	:	US
Telephone Number	:	561-900-4662
Fax Number	:	561-257-1231

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

Provider Enumeration Date	:	06/18/2007
Last Update Date	:	06/16/2025

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