Active NPI
Emily Rose Jellinek-Russo, PHD
- Clinical Child & Adolescent Psychologist
- Columbus, OH
National Provider Identifier
1669263174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- P.08791
- Practice address
- 380 Butterfly Gardens Dr
Columbus, OH 43215-7508 - Phone
- (614) 355-0569
- Fax
- (614) 355-7101
- NPI assigned
- May 14, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | P.08791 | OH | Primary |
Addresses
Primary practice location
380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Mailing address
700 Childrens Dr
Columbus, OH 43205-2639
Phone (614) 722-2000
Other practice location 1
187 W Schrock Rd
Westerville, OH 43081-2890
Phone (614) 355-8315
Other practice location 2
700 Childrens Dr
Columbus, OH 43205-2639
Phone (614) 722-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0131561 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P.08791 | OH | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750982400000",
"number": "1669263174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 CHILDRENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432052639",
"telephone_number": "614-722-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "380 BUTTERFLY GARDENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432157508",
"telephone_number": "614-355-0569",
"fax_number": "614-355-7101"
}
],
"practiceLocations": [
{
"address_1": "187 W Schrock Rd",
"address_purpose": "LOCATION",
"city": "Westerville",
"state": "OH",
"postal_code": "430812890",
"country_code": "US",
"telephone_number": "614-355-8315",
"fax_number": "614-355-8361",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "700 Childrens Dr",
"address_purpose": "LOCATION",
"city": "Columbus",
"state": "OH",
"postal_code": "432052639",
"country_code": "US",
"telephone_number": "614-722-4700",
"fax_number": "614-722-4718",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JELLINEK-RUSSO",
"first_name": "EMILY",
"middle_name": "ROSE",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-14",
"last_updated": "2025-06-27",
"certification_date": "2025-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "OH",
"license": "P.08791",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0131561",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.