Lindsey Russo

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-21-55559 Issued in GA

Practice address

5163 Roswell Rd
Atlanta, GA 30342-2206

Phone

(877) 288-4760

NPI assigned

Apr 17, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD

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

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1821418856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5163 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422206",
            "telephone_number": "877-288-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5163 ROSWELL RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422206",
            "telephone_number": "877-288-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "LINDSEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "1-21-55559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyren Russell
• Andrea Russo, MS, LAPC
• Deborah Anne Russo, PSY.D.
• John P Russo, MD
• Katherine Russo
• Valerie A Russo, PHARMD
• Clayton James Rust, MD
• Elara M Ruszkowski
• Karen K Ruszkowski, AA
• Amanda Ruth, M.D.

• Behavior Analyst in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.