| Michelle Russo, Lcsw | |
|
108 N Cayuga St Ithaca NY 14850-4346 | |
| (607) 760-4300 | |
| Not Available |
| Full Name | Michelle Russo, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 108 N Cayuga St, Ithaca, New York |
| Authorized Official Name and Position | Michelle Russo (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6077604300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Russo, Lcsw 108 N Cayuga St Ithaca NY 14850-4346 Ph: () - | Michelle Russo, Lcsw 108 N Cayuga St Ithaca NY 14850-4346 Ph: (607) 760-4300 |
| NPI Number | 1801368808 |
|---|---|
| Provider Enumeration Date | 01/02/2019 |
| Last Update Date | 01/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801368808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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