Marilyn Bryan Debernardo, LMHC, CASAC-G

Primary specialty

CounselorTaxonomy code 101Y00000X

License

002250-1 Issued in NY

Practice address

4 Technical Park
Suite #3, #6
Glens Falls, NY 12801

Phone

(518) 847-7803

Fax

(518) 280-5049

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Mental Health Counselor

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Behavioral Health Services North, Inc.Group PAC ID 3173511557, 68 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morrisonville, NY
  • NPI 1689621468

  NY

  Medicare reassignment Care Compare group NPD
• Behavioral Health Services North, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Queensbury, NY
  • NPI 1447005541
  NPD

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1407018591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 DUNSBACH PD",
            "city": "CLIFTON PARK",
            "state": "NY",
            "postal_code": "12065",
            "telephone_number": "518-847-7803",
            "fax_number": "518-280-5049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TECHNICAL PARK",
            "address_2": "SUITE #3, #6",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "12801",
            "telephone_number": "518-847-7803",
            "fax_number": "518-280-5049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Queensbury",
            "state": "NY",
            "postal_code": "128045882",
            "country_code": "US",
            "telephone_number": "518-926-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRYAN DEBERNARDO",
        "first_name": "MARILYN",
        "credential": "LMHC, CASAC-G",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11051",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "11051",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "002250-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420800",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley Trese Brown, MSW
• Kurt A Brown, CASAC
• Susan B Brown, CNM
• Abdul Qadir Brula, MD
• Suzanne Marie Brundage, PA
• Buffalo Vamc
• Heide Burch, PH.D.
• Paige Elizabeth Buser, PT, DPT
• Allison Butler
• Joan Butler

• All providers in Glens Falls, NY
• Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.