Active NPI
Randi Pettersen Marcinkiewicz, MA
- Mental Health Counselor
- Hubbardston, MA
National Provider Identifier
1336223874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 4144
- Practice address
- 38 Chippewa St
Hubbardston, MA 01452-1550 - Phone
- (978) 928-5554
- Fax
- (978) 630-5754
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 4144 | MA | Primary |
Addresses
Primary practice location
38 Chippewa St
Hubbardston, MA 01452-1550
Mailing address
38 Chippewa St
Hubbardston, MA 01452-1550
Phone (978) 928-5554
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4144 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336223874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 CHIPPEWA ST",
"city": "HUBBARDSTON",
"state": "MA",
"postal_code": "014521550",
"telephone_number": "978-928-5554",
"fax_number": "978-630-5754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 CHIPPEWA ST",
"city": "HUBBARDSTON",
"state": "MA",
"postal_code": "014521550",
"telephone_number": "978-928-5554",
"fax_number": "978-630-5754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCINKIEWICZ",
"first_name": "RANDI",
"middle_name": "PETTERSEN",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "4144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hubbardston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.