Individual
JOHN RUSSOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1616 18TH ST NW STE 111, WASHINGTON, DC 20009-2521
(202) 249-1163
(703) 658-9306
Mailing address
5510 LA PUERTA DEL SOL BLVD S APT 234, SAINT PETERSBURG, FL 33715-1426
(727) 710-5487
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17933
FL
Other
Enumeration date
10/12/2006
Last updated
08/24/2021
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