ANDREA SYNNESTVEDT RUSSELL LMSW - NPI 1992803795 - Social Worker in Traverse City, MI

Q: What is Andrea Russell's NPI number?

The NPI number for Andrea Russell is 1992803795. It was assigned to this individual provider in the NPPES registry on September 20, 2006.

Q: What is Andrea Russell's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Russell was last updated on January 17, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Andrea Synnestvedt Russell Lmsw NPPES

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

ANDREA SYNNESTVEDT RUSSELL LMSW (NPI 1992803795) is an individual social worker in Traverse City, Michigan, licensed in Michigan (6801085121) and active in the NPI registry since September 2006. She is enrolled in Medicare PECOS, is affiliated with Munson Medical Center, and maintains a secondary practice location in Traverse City.

NPPES Registry Identity

NPI1992803795

Entity TypeIndividualFemale

Primary Taxonomy104100000X

Provider Legal NameANDREA SYNNESTVEDT RUSSELLCredential: LMSW

Location Address4230 COPPER RIDGE DRTraverse City, MI 49684-7256

Mailing Address800 Cottageview Dr Ste 1076Traverse City, MI 49684-2614 · (231) 218-6664

Phone(231) 935-6380

Fax(231) 935-6920

Sole ProprietorYes

Medical School CMSOtherGraduated 1999

Enumeration DateSeptember 20, 2006

Last NPPES UpdateJanuary 17, 2024

NPPES CertifiedJanuary 17, 2024

✔ NPI 1992803795 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers

Taxonomy Code104100000X

License✔ Licensed in MI · 6801085121

Definition

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

4230 COPPER RIDGE DR, Traverse City, MI 49684

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Secondary Practice Location 1

Location 1800 Cottageview Dr Ste 1076Traverse City, MI 49684-2614 · Phone (231) 218-6664

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrea Synnestvedt Russell Lmsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406920339

PECOS Enrollment IDI20080811000332

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Munson Medical Center

Acute Care Hospitals · Traverse City, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230097

Location1105 Sixth StreetTraverse City, MI 49684 · Grand Traverse County

Emergency services Birthing friendly

Other Providers at the Same Location NPPES 9

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

NANCY LORENA GIFFELS FNP-BC

Nurse Practitioner (Family)