Individual provider · Type 1 NPI

Jill Marie Russell, LICSW

Clinical Social Worker · Brooklyn Center, MN

NPI number 1043149586 Active

Practice location

5421 Brooklyn Blvd
Brooklyn Center, MN 55429-3359

Mailing address

4148 Winnetka Ave N
New Hope, MN 55427-1210

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X22812 (MN)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1043149586

Jill Marie Russell, LICSW's National Provider Identifier is 1043149586, issued on May 19, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Brooklyn Center, MN. The record was last updated on May 19, 2026.