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

Nicole Russo, LISW

Individual provider Clinical Social Worker · NPI 1902411630

Nicole Russo, LISW is a Clinical Social Worker in Berea, Ohio. Licensed in Ohio. Registered with an NPI since 2020.

Licensed in
OH
In the registry since
2020
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

398 W Bagley Rd Ste 13
Berea, OH 44017-1312
Phone: (440) 970-3790
Fax: (440) 527-8043
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence I.2405587 (OH)

Record details

NPI number1902411630
Entity typeIndividual (Type 1)
GenderFemale
Credentials LISW
Sole proprietorNo
NPI enumeratedSeptember 10, 2020
Last updated in NPPESAugust 22, 2024
Certification dateAugust 22, 2024
Mailing address7519 Mentor Ave Ste 114, Mentor, OH 44060-5410

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