Individual
MS. JULIE BANNER RUSSELL
Active
Individual
MS. JULIE BANNER RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1016184
MA
1041C0700X
Clinical Social Worker
2067
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000P05767
BCBS
MA
01
—
007162
VALUE OPTIONS
MA
01
—
62-01666
UNITED BEHAVIORAL HEALTH
MA
01
—
773415
TUFTS HEALTH PLAN
MA
01
—
P05767
BCBSMA
MA
Enumeration date
07/27/2006
Last updated
01/15/2026
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