What is Kim Russo's NPI number?

The NPI number assigned to this healthcare provider is 1174964084, enumerated as a individual on July 9, 2013.

Where is the provider located?

The provider is located at 5965 S 900 E SALT LAKE CITY, UT 84121 and the phone number is (801) 263-7100.

What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101Y00000X.

KIM M RUSSO - NPI 1174964084 - Counselor in Salt Lake City, UT

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About Kim M Russo NPPES

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

KIM M RUSSO (NPI 1174964084) is an individual counselor in Salt Lake City, Utah and active in the NPI registry since July 2013.

NPPES Registry Identity

NPI1174964084

Entity TypeIndividualFemale

Primary Taxonomy101Y00000X

Provider Legal NameKIM M RUSSO

Location Address5965 S 900 ESalt Lake City, UT 84121-1720

Mailing Address5965 S 900 ESalt Lake City, UT 84121-1720 · (801) 263-7100

Phone(801) 263-7100

Sole ProprietorNo

Enumeration DateJuly 9, 2013

✔ NPI 1174964084 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

5965 S 900 E, Salt Lake City, UT 84121

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