Active NPI
Salenna Russello, TLLP
- Counseling Psychologist
- Saint Joseph, MI
National Provider Identifier
1780127183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 6301016962
- Practice address
- 1030 Miners Rd
Saint Joseph, MI 49085-9625 - Phone
- (269) 408-1688
- Fax
- (269) 408-1692
- NPI assigned
- Dec 2, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 6301016962 | MI | Primary |
Addresses
Primary practice location
1030 Miners Rd
Saint Joseph, MI 49085-9625
Mailing address
146 Maurice Blvd
Rio Grande, NJ 08242-1228
Phone (609) 602-6597
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301016962 | MI | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480636800000",
"number": "1780127183",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 MAURICE BLVD",
"city": "RIO GRANDE",
"state": "NJ",
"postal_code": "082421228",
"telephone_number": "609-602-6597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 MINERS RD",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "490859625",
"telephone_number": "269-408-1688",
"fax_number": "269-408-1692"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELLO",
"first_name": "SALENNA",
"credential": "TLLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-02",
"last_updated": "2016-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MI",
"license": "6301016962",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Joseph, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.