Individual provider · Type 1 NPI

Diane Russo, CASAC

Addiction (Substance Use Disorder) Counselor · North Babylon, NY

NPI number 1205474640 Active

Practice location

281 Phelps Ln
North Babylon, NY 11703-4005

Call (631) 422-7676 Map

Mailing address

894 Walnut Ave
Bohemia, NY 11716-4228

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1205474640

Diane Russo, CASAC's National Provider Identifier is 1205474640, issued on Dec 17, 2019. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in North Babylon, NY. The record was last updated on Nov 27, 2023.