Jaclyn Russo, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2014260 Issued in OH

Practice address

35575 Detroit Rd
Avon, OH 44011-1639

Phone

(440) 937-9660

NPI assigned

May 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1401062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1215349253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35575 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111639",
            "telephone_number": "440-937-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35575 DETROIT RD",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440111639",
            "telephone_number": "440-937-9660"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2133 Walter Rd",
            "address_purpose": "LOCATION",
            "city": "Westlake",
            "state": "OH",
            "postal_code": "441454320",
            "country_code": "US",
            "telephone_number": "216-308-9040",
            "fax_number": "440-734-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JACLYN",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "2014260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Rose, LPC
• Michael Edward Rowe, PA-C
• Emma Rueth, MS, RDN, LDN
• Carmen M. Ruffin, RN
• Darilynn Thomas Russell, M.D.
• Nadeh Sabeiha
• Susan Joyce Sabo, MD
• Saint Therese of Avon LLC
• Sirjana Sapkota
• Sarah Stranko, DC, Inc

• Speech-Language Pathologist in Avon, OH
• Providers in Avon, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.