1. Home
  2. Directory
  3. New York
  4. Coram
  5. Social Worker
  6. NPI Profile

COURTNEY RUSSO LCSW
NPI 1184188484
Social Worker - Clinical in Coram, NY

Active since January 31, 2019PECOS Enrolled
3600 ROUTE 112, CORAM, NY 11727(631) 920-8675(929) 244-4997 Get Directions Write a Review

NPPES record last updated: May 29, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 29, 2025, May 18, 2023, Jan 31, 2019 (3 updates tracked since 2019).

About Courtney Russo Lcsw NPPES

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

COURTNEY RUSSO LCSW (NPI 1184188484) is an individual clinical provider in Coram, New York, licensed in New York (093492) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1184188484
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameCOURTNEY RUSSOCredential: LCSW
Location Address3600 ROUTE 112Coram, NY 11727-4116
Mailing Address3600 Route 112Coram, NY 11727-4116 · (631) 920-8546 · Fax (929) 244-4997
Phone(631) 920-8675
Fax(929) 244-4997
Sole ProprietorYes
Medical School CMSOtherGraduated 2018
Enumeration DateJanuary 31, 2019
Last NPPES UpdateMay 29, 20253 updates tracked since enumeration
NPPES CertifiedMay 29, 2025
✔ NPI 1184188484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in NY · 093492
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
3600 ROUTE 112, Coram, NY 11727
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Courtney Russo Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID7214319557
PECOS Enrollment IDI20220802003382
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Courtney Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Welllife Network Inc.
Same address
Case Management
3600 ROUTE 112
Coram, NY 11727
  • Reassigned Medicare billing, New York enrollment
  • 49 clinicians in this Medicare group
NPI 1386817906 (631) 920-8302

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

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Group psychotherapy 90853
Group psychotherapy involves individuals discussing their issues in a group setting, led by a professional therapist. It provides a supportive environment where members can learn from each other's experiences, gain different perspectives, and develop new ways to handle challenges.
211 services16 patients
Psychotherapy, 45 minutes 90834
Psychotherapy is a treatment method where you converse with a therapist about your thoughts, feelings, and behaviors. In a 45-minute session, the therapist assists you in understanding and managing your mental health concerns, improving emotional wellness, and promoting personal growth.
205 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11727 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $67.40 – $203.53
Typical copayment $0.00 (range $16.85 – $50.88)
Most-billed visit code NA
Established Patient
$83.44 typical visit price
range $21.66 – $164.45
Typical copayment $20.86 (range $5.41 – $41.11)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAQUEL FERNANDES
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
ANNE KIRKHAM
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
JENNIFER HATFIELD
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (630) 920-8500
BIANCA ROLAND
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302
TRAVIS J WINGATE
Day Training/Habilitation Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8520
JENNIFER WILLA SIEGFRIED
Social Worker
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
SHANNON TIERNEY
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8610
ROSE PRISCILLA SANCHEZ
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302

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 Courtney Russo's NPI number?

The NPI number for Courtney Russo is 1184188484. It was assigned to this individual provider in the NPPES registry on January 31, 2019.

Where is Courtney Russo located?

Courtney Russo practices at 3600 Route 112, Coram, NY 11727. The listed phone number is (631) 920-8675.

What is Courtney Russo's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Courtney Russo enrolled in Medicare?

Yes. Courtney Russo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Courtney Russo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Courtney Russo reassigns Medicare benefits to Welllife Network Inc. (Coram, NY). The 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 Courtney Russo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Courtney Russo was last updated on May 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.