Kathleen Marino, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

PR057655-1 Issued in NY

Practice address

300 Center Dr
Riverhead Mental Health Clinic, Second Floor
Riverhead, NY 11901-3393

Phone

(631) 852-1440

NPI assigned

Nov 19, 2008

Last updated

Nov 19, 2008By 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1346495215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CENTER DR",
            "address_2": "RIVERHEAD MENTAL HEALTH CLINIC, SECOND FLOOR",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013393",
            "telephone_number": "631-852-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTER DR",
            "address_2": "RIVERHEAD MENTAL HEALTH CLINIC, SECOND FLOOR",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119013393",
            "telephone_number": "631-852-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "KATHLEEN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "PR057655-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUFFOLK COUNTY TAX ID",
            "identifier": "116000464",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY #  FOR SOCIAL WORKER",
            "identifier": "10410C0700X",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVERHEAD MH MEDICAID PROVIDER",
            "identifier": "00688179",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RIVERHEAD MH NPI",
            "identifier": "1104920313",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda A Mapp, L.M.S.W.
• Emilie M Marcinkowski, PA-C
• Pawan Marfatia, DO
• Eleanor Marin-Hurley
• Marina Homecare Agency of Ny, Inc.
• Mark J Coronel MD PC
• Glen Robert Mark, D.C.
• Nancy Szendy Mark, D.C.
• Nicole Marie Marky, NP
• Martin Drugs of Riverhead,Inc

• Clinical Social Worker in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.