Russo, Nancy

Russo, Nancy is an individual health care provider with primary practice located at 330 Kay Larkin Dr , Palatka FL 32177-2307. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Russo, Nancy can be contacted via phone (386) 385-1243.

Contact Information

Primary practice address
330 Kay Larkin Dr Palatka FL 32177-2307
Phone: (386) 385-1243
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH6919 Florida

Profile Details

NPI number 1881691087
LBN Legal business name Russo, Nancy
Credentials LMHC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2005
Last updated Apr 24th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881691087 NPPES
Florida MEDICAID 019791100

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