Individual provider Active NPI

Mariya I Martynenko, MA

  • Professional Counselor
  • Rochelle Park, NJ
National Provider Identifier
1215077227
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00315800 Issued in NJ
Practice address
340 W Passaic St Ste 1
Rochelle Park, NJ 07662-3019
Phone
(201) 488-5161
Fax
(201) 488-5162
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00315800 NJ Primary

Addresses

Primary practice location

340 W Passaic St Ste 1
Rochelle Park, NJ 07662-3019

Mailing address

452 River Rd Apt L
Nutley, NJ 07110-3639
Phone (973) 661-5234

Other practice location 1

452 River Rd.
Apt.L
Nutley, NJ 07110
Phone (973) 661-5234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20240229004318 NJ Practitioner - Mental Health Counselor 0749625689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

340 W Passaic St
Suite 1
Rochelle Park, NJ 07662-3019
Phone (201) 488-5161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
37PC00315800NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Revitalizing Psychiatry, P.C. CurrentSince Dec 23, 2023 Accepting new patients

Locations

795 Main St
Hackensack, NJ 07601
Phone (201) 488-5161

340 W Passaic St
Ste 1
Rochelle Park, NJ 07662
Phone (201) 488-5161

Organizations & group practices 1

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1215077227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 RIVER RD APT L",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071103639",
            "telephone_number": "973-661-5234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 W PASSAIC ST STE 1",
            "city": "ROCHELLE PARK",
            "state": "NJ",
            "postal_code": "076623019",
            "telephone_number": "201-488-5161",
            "fax_number": "201-488-5162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 River Rd.",
            "address_2": "Apt.L",
            "address_purpose": "LOCATION",
            "city": "Nutley",
            "state": "NJ",
            "postal_code": "07110",
            "country_code": "US",
            "telephone_number": "973-661-5234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTYNENKO",
        "first_name": "MARIYA",
        "middle_name": "I",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00315800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochelle Park, NJ

Sources for this page

Verify at the official NPI Registry.