Individual provider · Type 1 NPI

Diane Marie Russo

Mental Health Counselor · New York, NY

NPI number 1568022333 Active

Practice location

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027-4990

Mailing address

193 Guyon Ave
Staten Island, NY 10306-3946

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X100854-01 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1568022333

Diane Marie Russo's National Provider Identifier is 1568022333, issued on Jun 14, 2019. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in New York, NY. The record was last updated on Jun 14, 2019.