Marina Renee Rutkowski, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004620 Issued in GA

Practice address

1009 Frederick Rd
Catonsville, MD 21228-5055

Phone

(440) 467-0648

NPI assigned

Apr 11, 2007

Last updated

Nov 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Ms. Marina Renee Dantzler Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Carenow Services, LLC

  • Community/Behavioral Health Agency
  • Roswell, GA
  • NPI 1770713117
  NPD (past)

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1326261645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 ADANA RD STE D3",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212084745",
            "telephone_number": "317-313-0240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 FREDERICK RD",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212285055",
            "telephone_number": "440-467-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKOWSKI",
        "first_name": "MARINA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW 20571",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016449",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149013295",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143574400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARINA",
            "last_name": "DANTZLER",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "LCSW-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Catonsville, MD
• Providers in Catonsville, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.