Marilyn Diane Odom

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

13856 Issued in CA

Practice address

250 E Broadway Apt 505
Long Beach, CA 90802-6265

Phone

(707) 653-0294

NPI assigned

May 14, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/scharpca/r4/

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.

• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Los Angeles, CA
  • NPI 1083743082
  NPD (past)
• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1467775221
  NPD (past)

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1093564973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E BROADWAY APT 505",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026265",
            "telephone_number": "707-653-0294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E BROADWAY APT 505",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908026265",
            "telephone_number": "707-653-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "MARILYN",
        "middle_name": "DIANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "13856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adeyemi Oderinde-Mike
• Justina Ogheneovo Oderoha
• Ariel Elise Odlum, MD
• Jessica Chikaodili Odoh
• Gary Odom
• Stephen A Odom, PHD, MFT
• Michael Patrick Odonnell, MD
• Jill Oestreicher, N.P.
• Ofay Fitness & Health
• Miriam Ngozi Ofili, FNP

• Professional Counselor in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Professional Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.