NICOLE RUSSO LISW
NPI 1902411630
Social Worker - Clinical in Berea, OH

Q: What is Nicole Russo's NPI number?

The NPI number for Nicole Russo is 1902411630. It was assigned to this individual provider in the NPPES registry on September 10, 2020.

Q: What is Nicole Russo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Russo was last updated on August 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 September 10, 2020PECOS Enrolled

398 W BAGLEY RD STE 13, BEREA, OH 44017(440) 970-3790(440) 527-8043 Get Directions Write a Review

NPPES record last updated: August 22, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 22, 2024, Sep 10, 2020 (2 updates tracked since 2020).

On this page

About Nicole Russo Lisw NPPES

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

NICOLE RUSSO LISW (NPI 1902411630) is an individual clinical provider in Berea, Ohio, licensed in Ohio (I.2405587) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1902411630

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameNICOLE RUSSOCredential: LISW

Location Address398 W BAGLEY RD STE 13Berea, OH 44017-1312

Mailing Address7519 Mentor Ave Ste 114Mentor, OH 44060-5410 · (440) 701-6170 · Fax (440) 527-8043

Phone(440) 970-3790

Fax(440) 527-8043

Sole ProprietorNo

Enumeration DateSeptember 10, 2020

Last NPPES UpdateAugust 22, 20242 updates tracked since enumeration

NPPES CertifiedAugust 22, 2024

✔ NPI 1902411630 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 OH · I.2405587

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.

398 W BAGLEY RD STE 13, Berea, OH 44017

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Other Identifiers 1

Medicaid0416980OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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 Nicole Russo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Insight Counseling And Wellness LLC

32 mi

Mental Health (Including Community Mental Health Center)

7547 MENTOR AVE STE 300
Mentor, OH 44060

Reassigned Medicare billing, Ohio enrollment
20 clinicians in this Medicare group

NPI 1255846952 (440) 701-6170

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44017 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 $54.34 – $166.65

Typical copayment $0.00 (range $13.58 – $41.66)

Most-billed visit code NA

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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 15

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

CHLOE TODD LPC

Counselor (Mental Health)