Individual
MS. SUZANNE JENKINS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW CCM
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C-06618
NM
1041C0700X
Clinical Social Worker
Primary
LCSW-42025
ID
171M00000X
Case Manager/Care Coordinator
4247900
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15226379
—
NM
Enumeration date
08/30/2006
Last updated
07/22/2025
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