Jennifer Fay Marinellie, LCAS-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019984 Issued in NC

Practice address

205 Memorial Dr
Pinehurst, NC 28374-8712

Phone

(910) 295-2040

NPI assigned

Oct 13, 2023

Last updated

Nov 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jennifer Fay Daubenmeyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1033990122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EXECUTIVE PARK DR STE 100",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280251833",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 MEMORIAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748712",
            "telephone_number": "910-295-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINELLIE",
        "first_name": "JENNIFER",
        "middle_name": "FAY",
        "credential": "LCAS-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-29419",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "DAUBENMEYER",
            "middle_name": "FAY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Candace Renea Mansueto, QBA, LBA, IBA
• Matthew T Manzo, DO
• Joan Alberto Maradey, MD
• Stacy Leigh Murphy Marcum, PA-C
• Allison Barbara Marengo, DO
• James Thomas Marino, M.D.
• Barbara Wardwell Mark
• Marlboro Chesterfield Pathology, PC
• Marlboro Chesterfield Pathology, PC
• Donna M Marquis-Henke, RPH

• Clinical Social Worker in Pinehurst, NC
• Providers in Pinehurst, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.