Jennifer Lynn Russo, LPC, LCADC, ACS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37PC00571300 Issued in NJ

Practice address

13 Stillwater Rd
Blairstown, NJ 07825-9554

Phone

(908) 310-4323

NPI assigned

Mar 22, 2016

Last updated

Apr 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556064000000",
    "number": "1073975934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 STILLWATER RD",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078259554",
            "telephone_number": "908-310-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 STILLWATER RD",
            "city": "BLAIRSTOWN",
            "state": "NJ",
            "postal_code": "078259554",
            "telephone_number": "908-310-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "LPC, LCADC, ACS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2019-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00571300",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00239900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackie Re, LCADC
• Rem New Jersey, Inc.
• Rha Health Services NJ LLC
• Christine Michelle Rodesiler, FNP
• Lisa Ruffle, O.D.
• Eileen F. Schneider, A.T.,C.
• Robert Paul Schwartz, DMD
• Michael A Sefcik, DC
• Stillwater Health and Wellness LLC
• David E Stoner, RPH

• Mental Health Counselor in Blairstown, NJ
• Providers in Blairstown, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.