Jacquelyn Anne Marinello, MSED, BCBS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

434735101 Issued in NY

Practice address

81 Arlyn Drive East
Massapequa, NY 11758

Phone

(631) 327-0836

NPI assigned

Aug 8, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Licensed Applied Behavior Analyst Group, PLLC

  • Community/Behavioral Health Agency
  • Massapequa, NY
  • NPI 1184021479
  NPD (past)

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

{
    "created_epoch": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1043567118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 N MAIN ST STE 318",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117822512",
            "telephone_number": "631-327-0836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 ARLYN DRIVE EAST",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "11758",
            "telephone_number": "631-327-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINELLO",
        "first_name": "JACQUELYN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MSED, BCBS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2022-01-07",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": "434735101",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "000606",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Beatrice Marchena
• Nicholas A Marchese, DPM
• Robert Morton Marcus, MD
• Andrew M Margulies, DC
• Maria Corso, LCSW, P.C.
• Danielle Marino
• Kerry A Marino, OTR
• Nicole Marino, R.N.
• Sofia Marie Marinucci, MHC-LP
• Marjorie J Isdith DO PC

• School Psychologist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.