Marie J Russo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

004387 Issued in CT

Practice address

15 Berkshire Rd
Sandy Hook, CT 06482-1361

Phone

(203) 798-8278

NPI assigned

Mar 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Newtown Youth and Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sandy Hook, CT
  • NPI 1114015211
  NPD (past)

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459209600000",
    "number": "1841653854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BERKSHIRE RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821361",
            "telephone_number": "203-798-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BERKSHIRE RD",
            "city": "SANDY HOOK",
            "state": "CT",
            "postal_code": "064821361",
            "telephone_number": "203-798-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MARIE",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "004387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1548293343",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yaritza Rodriguez
• Joanna Lifshey Rosen, PSYD
• Emma Rubin, NCC, LPC
• Bonnie Curran Rumilly, LCSW
• Kathleen Elizabeth Ruopp, COTA/L
• Sandy Hook Behavioral Health LLC
• Victoria Scataglini, MSED. LPC
• Stephanie Ellen Schiff, DC,DCN,FACACN,LLC
• Thea Schiller, LPC
• Robert W Schmidt, LPC

• Clinical Social Worker in Sandy Hook, CT
• Providers in Sandy Hook, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.