Active NPI
Denese M Marino, PSYD, HSPP
- Clinical Psychologist
- Marion, IN
National Provider Identifier
1265409338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20041926
- Practice address
- 1700 E 38TH St
Marion, IN 46953-4568 - Phone
- (765) 674-3321
- Fax
- (765) 677-5115
- NPI assigned
- Mar 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20041926 | IN | Primary |
Addresses
Primary practice location
1700 E 38TH St
Marion, IN 46953-4568
Mailing address
1700 E 38TH St
Marion, IN 46953-4568
Phone (765) 674-3321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20041926 | IN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364947200000",
"number": "1265409338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 E 38TH ST",
"city": "MARION",
"state": "IN",
"postal_code": "469534568",
"telephone_number": "765-674-3321",
"fax_number": "765-677-5115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E 38TH ST",
"city": "MARION",
"state": "IN",
"postal_code": "469534568",
"telephone_number": "765-674-3321",
"fax_number": "765-677-5115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "DENESE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "PSYD, HSPP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-07",
"last_updated": "2013-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20041926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.