Kevin Marciniak

Primary specialty

Social WorkerTaxonomy code 104100000X

License

1049.028796 Issued in IL

Practice address

101 E Deyoung St
Marion, IL 62959-3128

Phone

(618) 693-9139

NPI assigned

Apr 7, 2025

Last updated

Oct 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Timber View Wellness Center LLC

  • Adult Mental Health Clinic/Center
  • Marion, IL
  • NPI 1316710098
  NPD

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1043004906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593128",
            "telephone_number": "618-693-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593128",
            "telephone_number": "618-693-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "KEVIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "1049.028796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Marie Mallow, MS, CCC-SLP
• Shalynn Malone
• Marvin Richard Mann, MS
• Chrystal T Manning, RN
• Mohammed Yusuf Mansuri, MD
• David William Marcum, PHARM.D.
• Marion Anesthesia Company LLC
• Marion Chronic Care LTD
• Marion Community Unit Dist 2
• Marion Diagnostic Center LLC

• Social Worker in Marion, IL
• Providers in Marion, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2025; 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.