Roland Italo Russoli Jr., MSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

SA60173796 Issued in WA

Practice address

3322 Broadway
Everett, WA 98201-4425

Phone

(425) 349-7289

NPI assigned

Oct 17, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Roland Russoli Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1619220514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3322 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014425",
            "telephone_number": "425-349-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3322 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014425",
            "telephone_number": "425-349-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOLI",
        "first_name": "ROLAND",
        "middle_name": "ITALO",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "SA60173796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROLAND",
            "last_name": "RUSSOLI",
            "credential": "MSW, MHP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Russell
• Morgan L Russell
• David A Russian, MD
• Carla Rae Russo, M.D.
• Franco Russo, M.D.
• Lindsay Allison Taggart Rutherford, DPT
• Margaret Joy Rutherford, ARNP
• Ciara Rutten
• Brenda Ruttenberg, PH.D.
• Cecille Ryalls, CNA

• Mental Health Counselor in Everett, WA
• Providers in Everett, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.