KAREN RUSSO PHD LLC
NPI 1104188762
Psychologist in Newark, DE

Active since June 11, 2012
500 CREEK VIEW RD, SUITE 109, NEWARK, DE 19711(302) 738-3140(302) 454-8026 Get Directions Write a Review

NPPES record last updated: April 1, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Karen Russo Phd Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAREN RUSSO PHD LLC (NPI 1104188762) is a healthcare organization registered as a psychologist in Newark, Delaware and active in the NPI registry since June 2012. The organization lists Karen Russo, Owner, Psychologist, as its authorized official.

NPPES Registry Identity

NPI1104188762
Entity TypeOrganization
Primary Taxonomy103T00000X
Legal Business NameKAREN RUSSO PHD LLC
Location Address500 CREEK VIEW RD, SUITE 109Newark, DE 19711-8549
Mailing Address500 Creek View Rd, Suite 109Newark, DE 19711-8549 · (302) 738-3140 · Fax (302) 454-8026
Fax(302) 454-8026
Organization SubpartNo
Authorized OfficialKaren RussoOwner, Psychologist · (302) 738-3140
Enumeration DateJune 11, 2012
Last NPPES UpdateApril 1, 2015
✔ NPI 1104188762 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in DE · B1-0000259
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
500 CREEK VIEW RD, Newark, DE 19711

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Karen Russo Phd Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateDelawareEnrollment IDO20120920000644Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Karen Russo Phd LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Clinical Psychologist
NPI 1073529905
500 CREEK VIEW RD SUITE 109
Newark, DE 19711
(302) 738-3140
✔ PECOSSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Karen Russo Phd LLC's NPI number?

The NPI number for Karen Russo Phd LLC is 1104188762. It was assigned to this organization in the NPPES registry on June 11, 2012.

Where is Karen Russo Phd LLC located?

Karen Russo Phd LLC is located at 500 Creek View Rd Suite 109, Newark, DE 19711. The listed phone number is (302) 738-3140.

What is Karen Russo Phd LLC's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Karen Russo Phd LLC enrolled in Medicare?

Yes. Karen Russo Phd LLC is registered in the Medicare PECOS enrollment system.

When is Karen Russo Phd LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Delaware, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Karen Russo Phd LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Karen Russo Phd LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Karen Russo Phd LLC was last updated on April 1, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.