Linda Eleanor Marsanico, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

012575 Issued in NY

Practice address

118 8TH Ave Apt 9E
Brooklyn, NY 11215-1528

Phone

(718) 636-1421

NPI assigned

Nov 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Dec 28, 2021 through Dec 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Prominis Medical Services PC

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1841323771
  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1326110214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 8TH AVE APT 9E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151528",
            "telephone_number": "718-636-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 8TH AVE APT 9E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112151528",
            "telephone_number": "718-636-1421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 12 St",
            "address_2": "Unit 1",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112157178",
            "country_code": "US",
            "telephone_number": "718-636-1421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSANICO",
        "first_name": "LINDA",
        "middle_name": "ELEANOR",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "012575",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NY",
            "license": "012575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01639770",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P773799",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Marroquin
• Byron Alexander Mars Jr.
• George Mars, RN
• Patricia Mars
• Wendy Mars
• Melissa Marseille, MD
• Ralph Marseille
• Johannes Marselis, LMSW
• Avalee Marsh
• Brianna Joy Marsh

• Counseling Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Counseling Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.