Matthew Charles Russoniello

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFTA.MG.61551477 Issued in WA

Practice address

400 S Jefferson St Ste 200
Spokane, WA 99204-3143

Phone

(509) 768-6852

NPI assigned

Sep 17, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Charmed Counseling

  • Clinical Social Worker
  • Spokane, WA
  • NPI 1972474021
  NPD
• Charmed Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Spokane, WA
  • NPI 1790298610
  NPD

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

{
    "created_epoch": "1631836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1215607494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S JEFFERSON ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043143",
            "telephone_number": "509-768-6852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S JEFFERSON ST STE 200",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992043143",
            "telephone_number": "509-768-6852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 S Division St",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992021510",
            "country_code": "US",
            "telephone_number": "509-838-4651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSONIELLO",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-17",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG61220659",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "MFTA.MG.61551477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan Russell
• Melissa D Russell, PA-C
• Michael Russell
• Raelynn Elizabeth Russell
• Christine Russo, LICSW, LMHC
• Heidi J Rust, RN
• James Arthur Ruster, RPH
• Nickolas J Rutecki
• James Rutherford, ACADC
• Robert E. Rutherford, M.D.

• Marriage & Family Therapist in Spokane, WA
• Providers in Spokane, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.

Verify at the official NPI Registry.