Active NPI
Brittany Shannon Russo, LMSW
- Social Worker
- Staten Island, NY
National Provider Identifier
1144992090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 113314
- Practice address
- 450 Seaview Ave
Staten Island, NY 10305-3401 - Phone
- (718) 226-6559
- NPI assigned
- Sep 29, 2021
- Last updated
- Sep 10, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 113314 | NY | Primary |
Addresses
Primary practice location
450 Seaview Ave
Staten Island, NY 10305-3401
Mailing address
450 Seaview Ave
Staten Island, NY 10305-3401
Other practice location 1
38 Winthrop Pl
Staten Island, NY 10314-3043
Phone (718) 727-7077
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113314 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crasmere Psychiatric Services, PC | Past | Accepting new patients | |
| Richmond Medical Solutions, PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Staten Island, NY
- NPI 1336450931
-
- Psychiatry Physician
- Staten Island, NY
- NPI 1427463124
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1632873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725926400000",
"number": "1144992090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SEAVIEW AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103053401",
"telephone_number": "718-226-6559"
}
],
"practiceLocations": [
{
"address_1": "38 Winthrop Pl",
"address_purpose": "LOCATION",
"city": "Staten Island",
"state": "NY",
"postal_code": "103143043",
"country_code": "US",
"telephone_number": "718-727-7077",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUSSO",
"first_name": "BRITTANY",
"middle_name": "SHANNON",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-29",
"last_updated": "2024-09-10",
"certification_date": "2024-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "113314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.