Russom Recovery Therapies LLC

Primary specialty

Social WorkerTaxonomy code 104100000X

Legal business name

RUSSOM RECOVERY THERAPIES LLC

Practice address

4519 Cascade Rd SE Ste 5
Grand Rapids, MI 49546-8319

Phone

(616) 228-2045

NPI assigned

Oct 3, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mary Beth Houpt

Title

Credentialing

Phone

(517) 676-9797

Specialties & licenses 1

Addresses

Other names 1

• LIFE RECOVERY THERAPY Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carlee Michelle Whitcome, LMSW

  • Social Worker
  • Grand Rapids, MI
  • NPI 1427422427
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1073154837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "MASON",
            "state": "MI",
            "postal_code": "488540010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 CASCADE RD SE STE 5",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468319",
            "telephone_number": "616-228-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSOM RECOVERY THERAPIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-03",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A",
        "authorized_official_last_name": "HOUPT",
        "authorized_official_first_name": "MARY BETH",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "517-676-9797"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE RECOVERY THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Gauck Russo, FNP
• Christopher Ross Russo, MD
• Randolph B Russo, MD
• Scott S Russo, MD
• Trevor Louis Russo, DO
• Drew Patrick Rust, MD
• Erica Bartlett Rustem, PA
• Kate Rustem, DPT
• Crystal Rusticus
• Michael Ruszkowski

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.