Individual provider · Type 1 NPI

Elizabeth Russo

Marriage & Family Therapist · San Bernardino, CA

NPI number 1639616212 Active

Practice location

621 Carnegie Dr Ste 210
San Bernardino, CA 92408-3548

Specialties and licenses

Taxonomy	Code	License
Behavior Technician	106S00000X	RBT-15-07640 (CA)
Marriage & Family Therapist	106H00000X	AMFT120953 (CA)
Marriage & Family Therapist Primary	106H00000X	LMFT143853 (CA)

Marriage & Family Therapist: A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats ment…

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About NPI 1639616212

Elizabeth Russo's National Provider Identifier is 1639616212, issued on Jan 20, 2017. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in San Bernardino, CA. The record was last updated on Apr 28, 2026.