SHANE RUSSELL LICSW
NPI 1164303046
Social Worker - Clinical in Minneapolis, MN

Active since September 09, 2025
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454(612) 273-6440 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Shane Russell Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE RUSSELL LICSW (NPI 1164303046) is an individual clinical provider in Minneapolis, Minnesota, licensed in Minnesota (28620) and active in the NPI registry since September 2025.

NPPES Registry Identity

NPI1164303046
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameSHANE RUSSELLCredential: LICSW
Location Address2450 RIVERSIDE AVEMinneapolis, MN 55454-1450
Mailing Address2450 Riverside AveMinneapolis, MN 55454-1450 · (612) 273-6440
Sole ProprietorNo
Enumeration DateSeptember 9, 2025
Last NPPES UpdateOctober 24, 2025
NPPES CertifiedSeptember 9, 2025
✔ NPI 1164303046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in MN · 28620
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2450 RIVERSIDE AVE, Minneapolis, MN 55454

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Rehabilitation Practitioner
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Pediatrics
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Internal Medicine (Geriatric Medicine)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Dietitian, Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Nurse Practitioner (Pediatrics, Critical Care)
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Internal Medicine
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Physician Assistant
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454
Nurse Anesthetist, Certified Registered
2450 RIVERSIDE AVE
MINNEAPOLIS, MN 55454

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Russell's NPI number?

The NPI number for Shane Russell is 1164303046. It was assigned to this individual provider in the NPPES registry on September 9, 2025.

Where is Shane Russell located?

Shane Russell practices at 2450 Riverside Ave, Minneapolis, MN 55454. The listed phone number is (612) 273-6440.

What is Shane Russell's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Shane Russell was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.