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

MS. Jessica Nicole Jack Russell, LISW

Individual provider Clinical Social Worker · NPI 1184776692

MS. Jessica Nicole Jack Russell, LISW is a Clinical Social Worker in Warren, Ohio. Graduated from University of Pittsburgh School of Medicine in 2007, 19 years ago. Practices with Rajendra P Koirala, MD, LLC, a 23-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Ohio.

Years since qualifying
19
Trained at
University of Pittsburgh School of Medicine
Licensed in
OH
In the registry since
2007
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

425 Niles Cortland Rd SE
Warren, OH 44484-2478
Phone: (330) 856-3975
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3 Kensington Sq, New Kensington, PA 15068-6443 — (724) 335-9733

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.1901879 (OH)

Record details

NPI number1184776692
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW
Sole proprietorNo
NPI enumeratedJanuary 17, 2007
Last updated in NPPESNovember 4, 2019

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolUNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduated 2007 (19 years in practice)
Group practice Rajendra P Koirala, M.D., Llc — 23 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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