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Michael R Russo
Mental Health Counselor in Jamestown, New York
NPI 1396873584

Michael R Russo is a Mental Health Counselor based in Mayville, NY and is specialized in Mental Health. Michael R Russo practices in Jamestown, NY. The NPI Number for Michael R Russo is 1396873584 and holds a License No. 003830 (New York).

The current practice location address for Michael R Russo is 200 E 3Rd St, Jamestown, NY and can be reached out via phone at 716-661-8330.

Location: 200 E 3Rd St, Jamestown, NY, 14757-1090
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396873584
Provider Name
Michael R Russo
Credential
Provider Entity Type
Individual
Gender
Male
Address
200 E 3Rd St, Jamestown, NY, 14757-1090
Phone Number
716-661-8330
Fax Number
Provider Enumeration Date
03/01/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
200 E 3Rd St
City
Jamestown
State
New York
Zip
14701-5433
Phone Number
716-661-8330
Fax Number
person
Provider Business Mailing Address Details
Address
200 E 3Rd St
City
Jamestown
State
New York
Zip
14701-5433
Phone Number
716-661-8330
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
003830 (New York)
Definition
Definition to come...
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