Marcie Josephine Daniluke, R138711040

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

R138711040 Issued in CA

Practice address

102 S 11TH St
San Jose, CA 95112-2132

Phone

(408) 998-5191

NPI assigned

Nov 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Pathway Society Inc

  • Substance Abuse Rehabilitation Facility
  • San Jose, CA
  • NPI 1902194095
  NPD (past)

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

{
    "created_epoch": "1637625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1083371124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 CONCORD AVE APT 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282862",
            "telephone_number": "408-849-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 S 11TH ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951122132",
            "telephone_number": "408-998-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANILUKE",
        "first_name": "MARCIE",
        "middle_name": "JOSEPHINE",
        "credential": "R138711040",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-23",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "R138711040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "ESST",
            "affiliation": "N",
            "address_1": "102 S 11th St",
            "city": "San Jose",
            "state": "CA",
            "country_code": "US",
            "postal_code": "951122132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Liane Daniell, LCSW
• Daniels Chiropractic, Inc
• Lisa Michelle Daniels, RD
• Pamela Daniels, CH
• Sandra Delores Daniels, M.A.
• Andrey Danilyuk
• Jillaine K. Danis, MFT
• Marina M Danker, PHARM. D
• Jason Danna
• Michael Allen Danner, LCSW

• Addiction (Substance Use Disorder) Counselor in San Jose, CA
• Providers in San Jose, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; 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.