Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JACLYN RUSSO, PHD
Active Sole ProprietorDR. JACLYN RUSSO, PHD is a Child, Clinical Psychologist healthcare provider located in CHARLOTTE, North Carolina. NPI 1962280024 is currently active in the NPPES registry. Verify at CMS.
Child, Clinical Psychologist · CHARLOTTE, NC
Registration Details
- NPI Number
- 1962280024
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 20, 2023 (2.9421838698942 yrs)
- Last Updated
- Sep 20, 2023
- License
-
6402 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4722 PARK RD STE BCHARLOTTE, NC, 282093802Browse NC providers · Browse ZIP 28209
- Phone
- 7046657424
- Primary Specialty
-
Child, Clinical Psychologist
103TC2200X
Other Child, Clinical Psychologist Providers in CHARLOTTE, NC
| Name | Credential | NPI |
|---|---|---|
| SHANNON ELIZABETH KERSEY | LPA | 1720190234 |
| DR. JAMMIE NOEL RAINEY | PH.D. | 1528191533 |
| NICOLLE ANDERSON | PH.D. | 1386859429 |
| DR. KAREN SHELTON | PH.D. | 1033354923 |
| DR. THERESA L. GIBSON | PH.D. | 1134365497 |
| RYAN MICHAEL KELLY | PH.D. | 1639622491 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.