Kristin Irene Russo, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

123924 Issued in MA

Practice address

9 Taunton GRN Unit 5
Taunton, MA 02780-3232

Phone

(716) 720-7051

NPI assigned

May 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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": "1462924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666483200000",
    "number": "1750737573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 TAUNTON GRN UNIT 5",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027803232",
            "telephone_number": "716-720-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 TAUNTON GRN UNIT 5",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "027803232",
            "telephone_number": "716-720-7051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1333 Iris Ave",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803042226",
            "country_code": "US",
            "telephone_number": "303-443-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "KRISTIN",
        "middle_name": "IRENE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-11",
        "last_updated": "2022-10-23",
        "certification_date": "2022-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "100546",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "123924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric James Ruby, MD
• Theresa E Ruby, PT, LMHC, PHD
• Mary Elizabeth Ruggiero, PSY.D., M.S.
• Amy E Runge, M.A.P.C.
• Andrea Russell, LICSW
• Lauren J Russo, M.S.
• RWW Home & Community Rehab Services, Inc. (Rehab Wthout Walls NeuroSolutions)
• Deirdre Brielle Ryan, BS
• Jamie Lee Ryan, MSW, LICSW
• Catharine Ryer, LICSW

• Clinical Social Worker in Taunton, MA
• Providers in Taunton, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.