Individual
DR. KELLY L RUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1767 VILLAGE PARK DR, ORANGEBURG, SC 29118-2475
(803) 776-4000
(803) 536-1719
Mailing address
715 DARLINGTON ST, COLUMBIA, SC 29201-1201
(239) 314-8511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY-8336
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
54516
—
ND
Enumeration date
08/18/2009
Last updated
05/01/2014
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us