Sandy Russo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

002149-1 Issued in NY

Practice address

3600 Jerome Ave
Bronx, NY 10467-1052

Phone

(718) 881-7600

Fax

(718) 654-1465

NPI assigned

Mar 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1720116445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HUNTER ST",
            "city": "MAMARONECK",
            "state": "NY",
            "postal_code": "105433108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 JEROME AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104671052",
            "telephone_number": "718-881-7600",
            "fax_number": "718-654-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "SANDY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002149-1",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teshera Chervelle Russell, LCSW
• Warren Russell
• Gemma Marie Russo
• Jaclyn Russo, M.S.
• Louis Russo III, ESQ. LMHC
• Steffani M Russo
• Genalin Albania Rustia, P.T.
• Jason Ruta, MSPT
• Katie Rose Rutcofsky, AU.D.
• Sharon Rutherford

• Mental Health Counselor in Bronx, NY
• Providers in Bronx, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.