Individual ProviderJanice Sanford-RussoSocial WorkerBehavioral Health & Social Service ProvidersPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819(216) 932-2800(216) 573-6946PECOS EnrollmentBased on the most recent information from CMS, provider Janice Sanford-Russo is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1528361474Provider TypeIndividualFull NameSanford-Russo, JaniceCredentialLISW-SGenderFemaleSole ProprietorYesEnumeration Date12/15/2010Last Updated12/15/2010Contact InformationPractice LocationPractice Address22001 Fairmount Blvd, Shaker Heights, OH 44118-4819Phone(216) 932-2800FaxUnlisted FaxMailing LocationMailing Address5708 Chestnut Rd, Independence, OH 44131-3371Phone(216) 573-6946FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense0004339Ohio