Individual provider Active NPI

John C Marino, LMHC,CASAC

  • Mental Health Counselor
  • Farmingdale, NY
National Provider Identifier
1023369295
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005145 Issued in NY
Practice address
1111 Broadhollow Rd
Farmingdale, NY 11735-4820
Phone
(800) 403-4360
NPI assigned
Sep 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 25796 NY
Mental Health Counselor 101YM0800X 005145 NY Primary

Addresses

Primary practice location

1111 Broadhollow Rd
Farmingdale, NY 11735-4820

Mailing address

1111 Broadhollow Rd
Suite 204
Farmingdale, NY 11735-4820
Phone (800) 403-4360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25796NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1023369295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 BROADHOLLOW RD",
            "address_2": "SUITE 204",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354820",
            "telephone_number": "800-403-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 BROADHOLLOW RD",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354820",
            "telephone_number": "800-403-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "JOHN",
        "middle_name": "C",
        "credential": "LMHC,CASAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "25796",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmingdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.