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

Shannon Russo

Individual provider Social Worker · NPI 1366388670

Shannon Russo is a Social Worker in Port Jefferson Station, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2026

Practice location Address checks out

1227 Main St
Port Jefferson Station, NY 11777-2227
Phone: (631) 312-1225
Show map & directions

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

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 120865 (NY)

Record details

NPI number1366388670
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 28, 2026
Last updated in NPPESApril 28, 2026
Certification dateApril 28, 2026

Other providers in Port Jefferson Station