Arussotherapy LLC Sacred Space Counseling

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

ARUSSOTHERAPY LLC SACRED SPACE COUNSELING

Doing business as

Andrea Russo LPC

Practice address

6595 Roswell Rd Ste G-6262
Atlanta, GA 30328-3152

Phone

(678) 856-6788

NPI assigned

May 18, 2021

Last updated

May 18, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrea Russo, LPCNPI 1114442001

Title

Ceo

Phone

(678) 856-6788

Specialties & licenses 1

Addresses

Other names 1

• Andrea Russo LPC Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrea Russo, MS, LAPC

  • Professional Counselor
  • Atlanta, GA
  • NPI 1114442001
  NPD Authorized official

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1326612938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6595 ROSWELL RD STE G-6262",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6595 ROSWELL RD STE G-6262",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283152",
            "telephone_number": "678-856-6788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3721 Forest Glen Dr",
            "address_purpose": "LOCATION",
            "city": "Pensacola",
            "state": "FL",
            "postal_code": "325047528",
            "country_code": "US",
            "telephone_number": "678-856-6788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARUSSOTHERAPY LLC SACRED SPACE COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-856-6788",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Andrea Russo LPC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Wences Arvelo
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• Roy D Ary, MD
• Swarn Vijay Arya, DO

• Professional Counselor in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.