Provider Demographics
NPI:1104573070
Name:BRITTANY RUSS' CLINICAL SOCIAL WORK AND THERAPY SERVICES LLC
Entity type:Organization
Organization Name:BRITTANY RUSS' CLINICAL SOCIAL WORK AND THERAPY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING & INSURANCE SPECIAL
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:NOWAKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-992-3617
Mailing Address - Street 1:PO BOX 873882
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-3882
Mailing Address - Country:US
Mailing Address - Phone:503-308-9563
Mailing Address - Fax:503-776-7719
Practice Address - Street 1:1827 NE 44TH AVE STE 310
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1468
Practice Address - Country:US
Practice Address - Phone:503-320-7136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty