Mary Russo

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

925 Route 73 N Ste H
Marlton, NJ 08053-1277

Phone

(609) 713-8763

NPI assigned

Jun 1, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1654041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1639818388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 ROUTE 73 N STE H",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531277",
            "telephone_number": "609-713-8763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 ROUTE 73 N STE H",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531277",
            "telephone_number": "609-713-8763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-01",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER LICENSE",
            "identifier": "R94585277161805",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.outreachrecovery.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "health information exchange",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "925 Route 73 N Ste H",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080531277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leah Rubba-Cameron, MSW, LCSW
• Aaron Rubenstein, PA-C
• Eric M. Rubin, MD
• Sharon Ruder, PT
• Bryan C Russell, DC
• Leigh Ryan
• Kristen Ryczak, M.D.
• Julienne Ryland, DO
• Adam C. Saalfelder, APN
• Bruce Anthony Sabino

• Counselor in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 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.