IndividualActive
Kelly Russo, PH.D.
NPI 1265664734 · Clinical Psychologist · Orangeburg, SC
Kelly Russo, PH.D. is a Clinical Psychologist provider in Orangeburg, SC (NPI 1265664734).
Provider details
- NPI number
- 1265664734
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- PY-8336 (FL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1767 Village Park Dr
Orangeburg, SC 29118-2475
Phone: (803) 776-4000
Fax: (803) 536-1719
Street-level locationGet directions
Mailing address
715 Darlington St
Columbia, SC 29201-1201
Registry dates
- Enumerated
- 2009-08-18
- Last updated
- 2014-05-01
Frequently asked questions
- What is Kelly Russo's NPI number?
- Kelly Russo's National Provider Identifier (NPI) is 1265664734, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kelly Russo's specialty?
- Kelly Russo is listed in the NPPES registry with a primary specialty of Clinical Psychologist (Behavioral Health & Social Service Providers).
- Where is Kelly Russo located?
- Kelly Russo's practice location on file with NPPES is 1767 Village Park Dr, Orangeburg, SC 29118-2475.
- What is Kelly Russo's phone number?
- The practice phone number listed in the NPPES registry for Kelly Russo is (803) 776-4000.
- Is Kelly Russo's NPI active?
- Yes — Kelly Russo's NPI (1265664734) is active in the NPPES registry as of the last update on 2014-05-01.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.