Individual provider Active NPI

Kristina Marik, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Round Lake, IL
National Provider Identifier
1134578529
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
31979 N Fish Lake Rd
Round Lake, IL 60073-9517
Phone
(847) 546-6450
NPI assigned
Jun 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

31979 N Fish Lake Rd
Round Lake, IL 60073-9517

Mailing address

519 S Warren Ave
Palatine, IL 60074-6423
Phone (845) 729-4083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190311001982 MA Practitioner - Clinical Social Worker 9830438761 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hri Clinics, Inc.Group PAC ID 8022088483, 104 clinicians

Practice addresses (Care Compare)

14 Fordham Rd
Allston, MA 02134-3000
Phone (617) 782-6460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Arbour Elder Services, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Marik Counseling, LLC Current Accepting new patients
Hri Clinics Inc CurrentSince Jan 21, 2019 Accepting new patients
Arbour Elder Services, Inc. CurrentSince Aug 1, 2021 Accepting new patients
Hri Clinics, Inc. CurrentSince Jan 21, 2019 Accepting new patients

Locations

14 Fordham Rd
Boston, MA 02134
Phone (617) 783-9676

100 Ledgewood Pl
Ste 202
Rockland, MA 02370
Phone (781) 871-6500

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1465257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465257600000",
    "number": "1134578529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 S WARREN AVE",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600746423",
            "telephone_number": "845-729-4083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31979 N FISH LAKE RD",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600739517",
            "telephone_number": "847-546-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIK",
        "first_name": "KRISTINA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-07",
        "last_updated": "2016-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Round Lake, IL

Sources for this page

Verify at the official NPI Registry.