Active NPI
Carrie Anne Russo
- Mental Health Counselor
- West Melbourne, FL
National Provider Identifier
1093657892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 630 S Wickham Rd Ste 107
West Melbourne, FL 32904-1429 - Phone
- (321) 608-0604
- NPI assigned
- Apr 8, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | FL | Primary |
Addresses
Primary practice location
630 S Wickham Rd Ste 107
West Melbourne, FL 32904-1429
Mailing address
1181 Palo Alto St SE
Palm Bay, FL 32909-7208
Phone (401) 602-8412
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alyssa Buchanan, LLC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775606400000",
"number": "1093657892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 PALO ALTO ST SE",
"city": "PALM BAY",
"state": "FL",
"postal_code": "329097208",
"telephone_number": "401-602-8412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S WICKHAM RD STE 107",
"city": "WEST MELBOURNE",
"state": "FL",
"postal_code": "329041429",
"telephone_number": "321-608-0604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "CARRIE",
"middle_name": "ANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-04-08",
"last_updated": "2026-04-08",
"certification_date": "2026-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.