Jaclyn Russo, PHD
Clinical Child & Adolescent Psychologist · Charlotte, NC
Jaclyn Russo, PHD is a clinical child & adolescent psychologist with a practice address in Charlotte, North Carolina, and NPI 1962280024, issued on Sep 20, 2023. Check the license (North Carolina 6402, as entered in NPPES) with the North Carolina board that licenses this profession; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Jaclyn Russo
- Credential
- PHD
- Primary taxonomy
- Clinical Child & Adolescent Psychologist 103TC2200X
- License number
- 6402 NC
Self-reported in NPPES; status is on the state search - Practice location
- 4722 Park RD Ste B, Charlotte, NC 28209
- Phone
- (704) 665-7424
- Enumerated
- Sep 20, 2023
- Record last updated
- Sep 20, 2023
- Entity
- Type 1 · individual
8 nearest clinical child & adolescent psychologist records → All 114 in North Carolina → Look up another NPI →
Verify Jaclyn Russo in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich North Carolina board licenses this profession
Search for license 6402Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Jaclyn Russo among 114 clinical child & adolescent psychologist records in North Carolina
Jaclyn Russo, PHD is one of 114 clinical child & adolescent psychologist records with a practice address in North Carolina. 4% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2023, is newer than 93% of them.
- NPI issued2023 · 93% of these records are older, 6% newer
- In a Medicare fileNo · 4% of these records are
- In the CMS Doctors and Clinicians fileNo · 9% of these records are
- Record last updated2023 · 64% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 103TC2200X and a North Carolina practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Clinical Child & Adolescent Psychologist providers in North Carolina
There are 114 clinical child & adolescent psychologist records in North Carolina. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 114 in North Carolina → Every provider in Charlotte → Clinical Child & Adolescent Psychologist nationwide →
The 8 clinical child & adolescent psychologist records with the nearest ZIP codes
- Shannon Kersey, LPACharlotte, NC 282111720190234
- Monica ChristopherCharlotte, NC 282121619632684
- Allison Hatley-Cotter, PH.D.Charlotte, NC 282031801569355
- Theresa Gibson, PH.D.Charlotte, NC 282261134365497
- Nicolle Anderson, PH.D.Charlotte, NC 282621386859429
- Radhika Unnithan, M.A., LPASalisbury, NC 281441215080528
- Ryan Kelly, PH.D.Charlotte, NC 282771639622491
- Karen Shelton, PH.D.Charlotte, NC 282771033354923
Common questions
What is Jaclyn Russo, PHD's NPI number?
Jaclyn Russo, PHD's National Provider Identifier (NPI) is 1962280024, issued on Sep 20, 2023. An NPI identifies a provider in billing; it is not a license.
Where is Jaclyn Russo, PHD located?
The NPPES record lists a practice address at 4722 Park RD Ste B, Charlotte, NC, 28209. Phone: (704) 665-7424. Providers update this record themselves, so call before visiting.
How can I verify Jaclyn Russo, PHD's license?
NPPES lists North Carolina license number 6402, as entered by the provider. Search the North Carolina board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.