Active NPI
Jeanie Marino
- Clinical Social Worker
- Milford, MA
National Provider Identifier
1356791867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 122799
- Practice address
- 221 E Main St
Suite 205
Milford, MA 01757-2825 - Phone
- (508) 902-0080
- Fax
- (508) 902-0066
- NPI assigned
- Jun 15, 2016
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 122799 | MA | Primary |
Addresses
Primary practice location
221 E Main St
Suite 205
Milford, MA 01757-2825
Mailing address
1445 Quaker St
Northbridge, MA 01534-1326
Phone (772) 276-9004
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 122799 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vendetti Wellness Group, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Community/Behavioral Health Agency
- Framingham, MA
- NPI 1952836546
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727913600000",
"number": "1356791867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1445 QUAKER ST",
"city": "NORTHBRIDGE",
"state": "MA",
"postal_code": "015341326",
"telephone_number": "772-276-9004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 E MAIN ST",
"address_2": "SUITE 205",
"city": "MILFORD",
"state": "MA",
"postal_code": "017572825",
"telephone_number": "508-902-0080",
"fax_number": "508-902-0066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "JEANIE",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-06-15",
"last_updated": "2024-10-03",
"certification_date": "2024-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "122799",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.