Russo, Marie J
Russo, Marie J is an sole proprietor health care provider with primary practice located at 15 Berkshire Rd , Sandy Hook CT 06482-1361. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Russo, Marie J can be contacted via phone (203) 798-8278.Contact Information
Primary practice address
15 Berkshire Rd
Sandy Hook CT 06482-1361
Phone: (203) 798-8278
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 004387 | Connecticut |
Profile Details
| NPI number | 1841653854 |
|---|---|
| LBN Legal business name | Russo, Marie J |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 29th, 2016 |
| Last updated | Mar 29th, 2016 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841653854 | NPPES |
| Connecticut | Other | 1548293343 | NPI |
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