Individual provider · Type 1 NPI

Courtney Russo, LCSW

Clinical Social Worker · Coram, NY

NPI number 1184188484 Active

Practice location

3600 Route 112
Coram, NY 11727-4116

Call (631) 920-8675 Map

Fax (929) 244-4997

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X093492 (NY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1184188484

Courtney Russo, LCSW's National Provider Identifier is 1184188484, issued on Jan 31, 2019. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Coram, NY. The record was last updated on May 29, 2025.