Provider Demographics
NPI:1487123527
Name:RUSSELL, RAMSAY LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:RAMSAY
Middle Name:LEIGH
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 CARROLL ST APT 5G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-1949
Mailing Address - Country:US
Mailing Address - Phone:315-427-5780
Mailing Address - Fax:
Practice Address - Street 1:466 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3140
Practice Address - Country:US
Practice Address - Phone:646-988-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0913401041C0700X
PACW0224051041C0700X
NJ44SC060531001041C0700X
NY102146104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical