Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kelly L Russo, PHD

Individual provider Clinical Psychologist · NPI 1265664734

Dr. Kelly L Russo, PHD is a Clinical Psychologist in Orangeburg, South Carolina. Practices as a sole proprietor. Licensed in Florida.

Licensed in
FL
In the registry since
2009
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1767 Village Park Dr
Orangeburg, SC 29118-2475
Phone: (803) 776-4000
Fax: (803) 536-1719
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PY-8336 (FL)

Record details

NPI number1265664734
Entity typeIndividual (Type 1)
GenderFemale
Credentials PHD
Sole proprietorYes
NPI enumeratedAugust 18, 2009
Last updated in NPPESMay 1, 2014

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