DR. JACQUELINE RUSSO (NPI# 1487121497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487121497 |
| Entity Type | Individual |
| Full Name | DR. JACQUELINE RUSSO |
| Credential | PSYD |
| Practice Address |
351 Manville Rd Ste 104 Pleasantville NY 10570-2166 |
| Mailing Address |
3083 23rd St Apt 2a Astoria NY 11102-3325 |
| Practice Telephone | 4133849240 |
| Mailing Telephone | 5163171876 |
| Enumeration Date | 2018-10-28 |
| Last Update Date | 2018-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 022242-1 | NY | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225558604 | Jacqueline Russo | Dentist | 11676 Dunes Rd, Boynton Beach, FL 33436-5503 | 2017-06-26 |
| 1316028376 | Jacqueline Jaudon Russo | Pathology | 5427 Sw 75th Ter, Gainesville, FL 32608-4413 | 2006-10-18 |
| 1750860458 | Jacqueline Russo | Physical Therapy Assistant | 120 Seminary Ave, Auburndale, MA 02466-2650 | 2018-08-13 |
| Street Address |
351 MANVILLE RD STE 104 |
| City | PLEASANTVILLE |
| State | NY |
| Zip Code | 10570-2166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669984472 | Jillian Anderson | Counselor | 351 Manville Rd Ste 104, Pleasantville, NY 10570-2166 | 2017-11-02 |
| 1710584883 | Willow Bend Counseling LLC | Clinic/Center | 351 Manville Rd Ste 104, Pleasantville, NY 10570-2166 | 2020-10-02 |
| 1336763341 | Talia Shiovitz | Social Worker | 351 Manville Rd Ste 104, Pleasantville, NY 10570-2166 | 2020-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356983597 | Lorraine Elizabeth Roes | Social Worker | Jcca Start Roes, 1075 Broadway, Pleasantville, NY 10570 | 2019-10-09 |
| 1700376720 | Pilar B. Wellansky | Psychologist | 400 Bedford Road, Room #207, Pleasantville, NY 10570 | 2018-05-15 |
| 1073021606 | Seokmin Han | Counselor | 411 Manville Rd, Pleasantville, NY 10570 | 2018-01-17 |
| 1891186771 | Daria Joan Zetlen | Social Worker | 51 Cedar Ave, Pleasantville, NY 10570 | 2015-02-12 |
| 1023437753 | Sheree L Loftus | Nurse Practitioner | 4 Stella Lane, Pleasantville, NY 10570 | 2014-04-09 |
| 1508123639 | Philip B. Blank Jr. D.o. P.C. | Dermatology | 325 Manville Rd., Pleasantville, NY 10570 | 2012-04-13 |
| 1760759476 | Elizabeth N. Sousa | Family Medicine | 130, Lake Shore Drive, Pleasantville, NY 10570 | 2011-11-23 |
| 1265714414 | Josephine B Reyes | Registered Nurse | 25 Booth Street, Pleasantville, Pleasantville, NY 10570 | 2011-09-14 |
| 1619121175 | Karen Ann Teters | Physical Therapist | 54 Washington Ave, Pleasantville, NY 10570 | 2008-11-11 |
| 1447411400 | Christina A. Repp | Social Worker | 351 Manville Rd., Suite 109, Pleasantville, NY 10570 | 2008-06-23 |
| Find all providers in zip 10570 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700376720 | Pilar B. Wellansky | Psychologist | 400 Bedford Road, Room #207, Pleasantville, NY 10570 | 2018-05-15 |
| 1689707580 | Dennis Thornton | Psychologist | 24 S View St, Pleasantville, NY 10570-3329 | 2007-03-13 |
| 1194864215 | Carla Paganelli | Psychologist | 427 Bedford Rd, Suite 340, Pleasantville, NY 10570-3029 | 2007-02-05 |
| 1306907746 | Elissa Lefkowitz | Psychologist | 25 Pheasant Run Rd, Pleasantville, NY 10570-2512 | 2006-12-12 |
| 1548335391 | Dennis R. Thornton, Phd | Psychologist | 24 South View Street, Pleasantville, NY 10570 | 2006-11-21 |
| 1952380941 | Karen Levine | Psychologist | 20 Club Ct, Pleasantville, NY 10570 | 2006-01-10 |
| 1508490871 | Jessica Amber Schutte | Psychologist | 1075 Broadway, Pleasantville, NY 10570-2346 | 2020-02-26 |
| 1841823531 | Ashley Elizabeth Feldman | Psychologist | 1075 Broadway, Pleasantville, NY 10570-2346 | 2020-02-20 |
| 1477078152 | Jared Reginald Mcshall | Psychologist | 351 Manville Rd, Pleasantville, NY 10570-2152 | 2017-08-03 |
| 1053777128 | Matthew Harris | Psychologist | 351 Manville Rd, Suite 101, Pleasantville, NY 10570-2152 | 2016-01-05 |
| Find all providers in PLEASANTVILLE | ||||
| City | PLEASANTVILLE |
| Zip Code | 10570 |
Please comment or provide details below to improve the information on DR. JACQUELINE RUSSO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.