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

Nicole Russo

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1235647314

Nicole Russo is an Addiction (Substance Use Disorder) Counselor in Philadelphia, Pennsylvania. Registered with an NPI since 2018.

In the registry since
2018

Practice location Address checks out

9815 Roosevelt Blvd
Philadelphia, PA 19114-1035
Phone: (616) 644-6464
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X

Record details

NPI number1235647314
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 11, 2018
Last updated in NPPESJanuary 11, 2018

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