Nathanael William Russell, LMSW, QMHP | |
3111 Electric Ave, Port Huron, MI 48060-8127 | |
(810) 966-7898 | |
Not Available |
Full Name | Nathanael William Russell |
---|---|
Gender | Male |
Speciality | Clinical Social Worker |
Experience | 4 Years |
Location | 3111 Electric Ave, Port Huron, Michigan |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093344681 | NPI | - | NPPES |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Clair County Community Mental Health Authority | 7416861984 | 56 |
Entity Name | St Clair County Community Mental Health Authority |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689783672 PECOS PAC ID: 7416861984 Enrollment ID: O20031118000783 |
Mailing Address | Practice Location Address |
---|---|
Nathanael William Russell, LMSW, QMHP 2837 Walnut St, Port Huron, MI 48060-2162 Ph: (810) 858-1759 | Nathanael William Russell, LMSW, QMHP 3111 Electric Ave, Port Huron, MI 48060-8127 Ph: (810) 966-7898 |
Sara M Tavora, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 520 Superior St, Port Huron, MI 48060 Phone: 810-984-4202 Fax: 810-984-8896 | |
Heather Stewart, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Callie Gunn, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mr. Robert Marshall Ii, LLMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Kristen M Azzinaro, Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Mrs. Deborah Louise Kokoszka, LMSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Ms. Erin Michelle Mcdaid, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2601 13th St, Port Huron, MI 48060 Phone: 810-987-9100 Fax: 810-987-9105 |