Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Stephen John Russo, PHD

Individual provider Clinical Psychologist · NPI 1093826778

Dr. Stephen John Russo, PHD is a Clinical Psychologist in Mineola, New York. Qualified in 1991, 35 years ago. Accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
35
Licensed in
NY
In the registry since
2006
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

302 Willis Ave
Mineola, NY 11501
Phone: (516) 448-3015
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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 0113131 (NY)

Record details

NPI number1093826778
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedAugust 31, 2006
Last updated in NPPESJuly 8, 2007
Mailing address20 Whistlerhill Lane, Huntington, NY 11743

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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