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

Individual provider Clinical Social Worker · NPI 1295266674

Theresa Russell, LCSW is a Clinical Social Worker in Boynton Beach, Florida. Qualified in 1996, 30 years ago. Practices with Senior Living Memory Health Inc, a 111-clinician group and accepts Medicare assignment. Licensed in Florida and New York.

Years since qualifying
30
Licensed in
FL, NY
In the registry since
2017
Specialties on file
2
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

350 N Federal Hwy 715
Boynton Beach, FL 33435-4171
Phone: (631) 793-1365
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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 SW12181 (FL)
Clinical Social Worker Taxonomy 1041C0700X · Licence R053958-1 (NY)

Record details

NPI number1295266674
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 27, 2017
Last updated in NPPESMarch 27, 2017

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Senior Living Memory Health Inc — 111 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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