Individual provider Active NPI

Adrienne Clark Marino, LPC

  • Professional Counselor
  • Wyomissing, PA
National Provider Identifier
1366037087
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC018457 Issued in PA
Practice address
1105 Berkshire Blvd Ofc 110
Wyomissing, PA 19610-1248
Phone
(610) 374-4963
Fax
(610) 378-5403
NPI assigned
Mar 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X BH05521 PA
Professional Counselor 101YP2500X PC018457 PA Primary

Addresses

Primary practice location

1105 Berkshire Blvd Ofc 110
Wyomissing, PA 19610-1248

Mailing address

507 Gregg St
Shillington, PA 19607-1333
Phone (610) 823-0116

Other practice location 1

507 Gregg St
Shillington, PA 19607-1333
Phone (610) 823-0116

Other names 1

  • Adrienne Marino Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250519003091 PA Practitioner - Mental Health Counselor 6103344551 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Guidance CenterGroup PAC ID 1850291303, 22 clinicians

Practice addresses (Care Compare)

1105 Berkshire Blvd
Ofc 110
Wyomissing, PA 19610-1249
Phone (610) 374-4963

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BH05521PAMDMental Health Counselor
PC018457PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Guidance Center CurrentSince Apr 8, 2025 Accepting new patients
Sondermind, P.a. Mental Health CurrentSince Jan 1, 2026 Accepting new patients
Access Services Inc. PastSince Dec 7, 2025 Accepting new patients

Locations

3570 Old Route 22
Hamburg, PA 19526
Phone (610) 374-4963

1650 Market St
Philadelphia, PA 19103
Phone (215) 514-0760

1105 Berkshire Blvd
Ofc 110
Wyomissing, PA 19610
Phone (610) 374-4963

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1366037087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 GREGG ST",
            "city": "SHILLINGTON",
            "state": "PA",
            "postal_code": "196071333",
            "telephone_number": "610-823-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 BERKSHIRE BLVD OFC 110",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101248",
            "telephone_number": "610-374-4963",
            "fax_number": "610-378-5403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "507 Gregg St",
            "address_purpose": "LOCATION",
            "city": "Shillington",
            "state": "PA",
            "postal_code": "196071333",
            "country_code": "US",
            "telephone_number": "610-823-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK MARINO",
        "first_name": "ADRIENNE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-04",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "BH05521",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC018457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "MARINO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.