KELLY O'ROURKE-RUSSELL (LCSW) – Clinical Social Worker, NPI 1093061962

KELLY O'ROURKE-RUSSELL (LCSW) is a healthcare provider. based in Blacksburg, Virginia. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. 0904006467 (VA). The NPI Number for KELLY O'ROURKE-RUSSELL (LCSW) is 1093061962

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
KELLY O'ROURKE-RUSSELL (LCSW)
NPI
1093061962
Phone
(540) 961-8459
Address
700 UNIVERSITY CITY BLVD
Enumeration Date
30 July 2012
Last Update Date
30 July 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5409212238
Graduation Year
2002 (24 years ago)
PAC ID
5294982443
Group Practice PAC ID
3173518230
Professional Enrollment ID
I20120823000597
Address ID
VA241341660PE705XXAVEX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,023 CLINICAL SOCIAL WORKER in VA

Provider Addresses for KELLY O'ROURKE-RUSSELL (LCSW)

  • 700 UNIVERSITY CITY BLVD

    BLACKSBURG, VA 240602706

    Phone: (540) 961-8459

    Fax: (540) 443-0053

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-08-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120823000597IClinical Social WorkerVATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90837Psychotherapy, 1 hour6311$0
View full utilization report →

Insurance plans in this area (ZIP 24060)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3173518230View full group profile
NameSpecialtyState
Psychiatry, Addiction Medicine, Geriatric PsychiatryVA
Clinical Social WorkerVA
Mental Health CounselorVA
Clinical Social WorkerVA
Clinical Social WorkerVA
Mental Health CounselorVA
Mental Health CounselorVA
Nurse PractitionerVA
P S Y C H I A T R YVA
P S Y C H I A T R YWV

Reviews

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Frequently asked questions

What federal number belongs to KELLY O'ROURKE-RUSSELL (LCSW)?
The federal identifier for KELLY O'ROURKE-RUSSELL (LCSW) is NPI 1093061962.
Is KELLY O'ROURKE-RUSSELL (LCSW) active in the national directory?
KELLY O'ROURKE-RUSSELL (LCSW)'s public NPI profile is in an active state.
What field does KELLY O'ROURKE-RUSSELL (LCSW) work in?
You can think of KELLY O'ROURKE-RUSSELL (LCSW) as practicing within Clinical Social Worker. Clinical services aligned with this taxonomy classification.
Where does public data place KELLY O'ROURKE-RUSSELL (LCSW)?
The snapshot lists Blacksburg, Virginia for KELLY O'ROURKE-RUSSELL (LCSW); download NPPES for the complete set.
How can I contact KELLY O'ROURKE-RUSSELL (LCSW)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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