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Diane Russo, CASAC
Addiction (Substance Use Disorder) Counselor in North Babylon, New York
NPI 1205474640

Diane Russo is an Addiction (Substance Use Disorder) Counselor based in Bohemia, NY and is specialized in Addiction (Substance Use Disorder). Diane Russo practices in North Babylon, NY and has the professional credentials of CASAC. The NPI Number for Diane Russo is 1205474640 and holds a License No. (New York).

The current practice location address for Diane Russo is 281 Phelps Ln, North Babylon, NY and can be reached out via phone at 631-422-7676.

Location: 281 Phelps Ln, North Babylon, NY, 11716-4228
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205474640
Provider Name
Diane Russo
Credential
CASAC
Provider Entity Type
Individual
Gender
Female
Address
281 Phelps Ln, North Babylon, NY, 11716-4228
Phone Number
631-422-7676
Fax Number
Provider Enumeration Date
12/17/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0009943 01 NY OASAS CASAC
institution
Provider Business Practice Location Address Details
Address
281 Phelps Ln
City
North Babylon
State
New York
Zip
11703-4005
Phone Number
631-422-7676
Fax Number
person
Provider Business Mailing Address Details
Address
281 Phelps Ln
City
North Babylon
State
New York
Zip
11703-4005
Phone Number
631-422-7676
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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