JOAN CAROL RUSSO PH.D.
NPI 1225037575
Psychologist - Clinical in Oconomowoc, WI

Q: What is Joan Russo's NPI number?

The NPI number for Joan Russo is 1225037575. It was assigned to this individual provider in the NPPES registry on July 19, 2005.

Q: What is Joan Russo's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

Q: When was this NPI record last updated?

The NPPES record for Joan Russo was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.

Active since July 19, 2005

W340N6509 BREEZY POINT RD, OCONOMOWOC, WI 53066(262) 490-9114 Get Directions Write a Review

NPPES record last updated: July 7, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Joan Carol Russo Ph.d. NPPES

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

JOAN CAROL RUSSO PH.D. (NPI 1225037575) is an individual clinical provider in Oconomowoc, Wisconsin, licensed in Wisconsin (1169) and active in the NPI registry since July 2005.

NPPES Registry Identity

NPI1225037575

Entity TypeIndividualFemale

Primary Taxonomy103TC0700X

Provider Legal NameJOAN CAROL RUSSOCredential: PH.D.

Location AddressW340N6509 BREEZY POINT RDOconomowoc, WI 53066-5132

Mailing AddressW340n6509 Breezy Point RdOconomowoc, WI 53066-5132 · (262) 490-9114

Phone(262) 490-9114

Sole ProprietorYes

Enumeration DateJuly 19, 2005

Last NPPES UpdateJuly 7, 2014

✔ NPI 1225037575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologist · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code103TC0700X

License✔ Licensed in WI · 1169

Definition

A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems.

W340N6509 BREEZY POINT RD, Oconomowoc, WI 53066

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Other Identifiers 3

Medicare UPINR78219WI

Medicare ID-Type Unspecified000084821WI

Medicaid39114000WI

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 Joan Russo's NPI number?

The NPI number for Joan Russo is 1225037575. It was assigned to this individual provider in the NPPES registry on July 19, 2005.

Where is Joan Russo located?

Joan Russo practices at W340n6509 Breezy Point Rd, Oconomowoc, WI 53066. The listed phone number is (262) 490-9114.

What is Joan Russo's specialty?

The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.

When was this NPI record last updated?

The NPPES record for Joan Russo was last updated on July 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.