Individual
GINAMARIE RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT, LMHC
Contact information
Practice address
4651 SALISBURY RD STE 400, JACKSONVILLE, FL 32256-6187
(646) 941-7645
(929) 596-7897
Mailing address
4651 SALISBURY RD STE 400, JACKSONVILLE, FL 32256-6187
(646) 941-7645
(929) 596-7897
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH23542
FL
106H00000X
Marriage & Family Therapist
Primary
MT4813
FL
Other
Enumeration date
02/11/2021
Last updated
08/13/2025
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