Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jai Kieron Rene Russell, LCSW

Individual provider Clinical Social Worker · NPI 1972162683

Jai Kieron Rene Russell, LCSW is a Clinical Social Worker in Bozeman, Montana. Qualified in 1998, 28 years ago. Accepts Medicare assignment. Licensed in Montana.

Years since qualifying
28
Licensed in
MT
In the registry since
2019
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2135 Charlotte St Ste 2
Bozeman, MT 59718-2741
Phone: (206) 930-8970
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence BBH-LCSW-LIC-38038 (MT)

Record details

NPI number1972162683
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 7, 2019
Last updated in NPPESDecember 8, 2021
Certification dateDecember 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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