NICOLE RUSSO
NPI 1235647314
Counselor - Addiction (Substance Use Disorder) in Philadelphia, PA

Active since January 11, 2018
9815 ROOSEVELT BLVD, PHILADELPHIA, PA 19114(616) 644-6464 Get Directions Write a Review

NPPES record last updated: January 11, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nicole Russo NPPES

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

NICOLE RUSSO (NPI 1235647314) is an individual addiction (substance use disorder) provider in Philadelphia, Pennsylvania and active in the NPI registry since January 2018.

NPPES Registry Identity

NPI1235647314
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameNICOLE RUSSO
Location Address9815 ROOSEVELT BLVDPhiladelphia, PA 19114-1035
Mailing Address680 American AveKing Of Prussia, PA 19406-4023 · (616) 644-6464 · Fax (610) 981-6078
Sole ProprietorNo
Enumeration DateJanuary 11, 2018
NPI 1235647314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
9815 ROOSEVELT BLVD, Philadelphia, PA 19114

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.

Nurse Practitioner
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114
Counselor (Addiction (Substance Use Disorder))
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114
Counselor (Professional)
9815 ROOSEVELT BLVD, SUITE B
PHILADELPHIA, PA 19114
Physical Therapist
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114
Counselor (Mental Health)
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114
Art Therapist
9815 ROOSEVELT BLVD, SUITE B
PHILADELPHIA, PA 19114
Social Worker
9815 ROOSEVELT BLVD, SUITE B
PHILADELPHIA, PA 19114
Physical Therapist
9815 ROOSEVELT BLVD
PHILADELPHIA, PA 19114

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 Nicole Russo's NPI number?

The NPI number for Nicole Russo is 1235647314. It was assigned to this individual provider in the NPPES registry on January 11, 2018.

Where is Nicole Russo located?

Nicole Russo practices at 9815 Roosevelt Blvd, Philadelphia, PA 19114. The listed phone number is (616) 644-6464.

What is Nicole Russo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Nicole Russo was last updated on January 11, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.