Individual
MRS. CARRIE BETH RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
189 37TH ST, LINDENHURST, NY 11757-2604
(631) 275-1389
Mailing address
189 37TH ST, LINDENHURST, NY 11757-2604
(631) 275-1389
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
033620
NY
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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