David Patrick Russo, MA, LMFT, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

3364 Issued in MA

Practice address

800 Main St
Holden, MA 01520-1838

Phone

(508) 829-4242

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in MA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1871605113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 JACKSON ST",
            "city": "JEFFERSON",
            "state": "MA",
            "postal_code": "015221413",
            "telephone_number": "508-366-4000",
            "fax_number": "508-870-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MAIN ST",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015201838",
            "telephone_number": "508-829-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "DAVID",
        "middle_name": "PATRICK",
        "credential": "MA, LMFT, LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MA",
            "license": "887",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "3364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Roberts, P.T.
• Michael Alan Roberts, PT
• Karin Rondeau, NP
• Peter W Rugg, MD
• Anne Paulette Russo, LICSW
• Rutland Family Health Center
• Safewayluxurytransportation L.L.C.
• Sandy Lor DMD LLC (Holden Family Dentist)
• Pamela J Sansoucy, M.D.
• Nicole Scalfani-Leroux, LCSW

• Mental Health Counselor in Holden, MA
• Providers in Holden, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2019; 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.