BONNIE RUSSO LCSW QS NPI 1366922288

NPI Information

  • NPI: 1366922288
  • Provider Name: BONNIE RUSSO, LCSW, QS
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1729 NW SAINT LUCIE WEST BLVD # 1276
    PORT SAINT LUCIE, FL
    ZIP 34986
  • Phone: (561) 412-9281

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NPI Details

Bonnie Russo, LCSW, QS is a mental health counselor in Port Saint Lucie, FL with 11 years of experience. Bonnie Russo, LCSW, QS NPI is 1366922288. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1729 NW SAINT LUCIE WEST BLVD # 1276
PORT SAINT LUCIE, FL
ZIP 34986-501
Phone: (561) 412-9281
Fax: (620) 522-8594

The NPI 1366922288 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 8/20/2018 and was last updated on 11/25/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171M00000XCase Manager/Care CoordinatorSW15096FLORIDANo
21041C0700XSocial WorkerClinicalSW15096FLORIDANo
3104100000XSocial WorkerSW15096FLORIDANo
4101YM0800XCounselorMental HealthSW15096FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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