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Individual

ALESSIA RUSSELLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3109 37TH ST, ASTORIA, NY 11103-3932
(718) 721-4300
Mailing address
15449 21ST AVE, WHITESTONE, NY 11357-3829
(718) 309-0405

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
104756
NY
1041C0700X
Clinical Social Worker
Primary
094266
NY

Other

Enumeration date
11/19/2018
Last updated
06/06/2024
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