Individual provider Active NPI

Marinna Mil Marotta, LPC LCPC CSAC PMH-C

  • Professional Counselor
  • Elkhorn, WI
National Provider Identifier
1528577277
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6576125 Issued in WI
Practice address
209 Oconnor Dr
Elkhorn, WI 53121-4269
Phone
(262) 374-5251
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16192131 WI
Professional Counselor 101YP2500X 180.011635 IL
Professional Counselor 101YP2500X 6576125 WI Primary

Addresses

Primary practice location

209 Oconnor Dr
Elkhorn, WI 53121-4269

Mailing address

209 Oconnor Dr
Elkhorn, WI 53121-4269
Phone (262) 374-5251

Other practice location 1

4306 W Solon Rd
Richmond, IL 60071-9738
Phone (262) 374-5251

Other identifiers 2

IdentifierTypeStateIssuer
6576-125OtherWILICENSED PROFESSIONAL COUNSELOR
180.011635OtherILLICENSED CLINICAL PROFESSIONAL COUNSELOR

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

LicenseStateTypeSpecialty
16192131WIMDAddiction (Substance Use Disorder) Counselor
180.011635ILMDProfessional Counselor
6576125WIMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
All Encompassing Counseling LLC Current Accepting new patients

Locations

209 Oconnor Dr
Elkhorn, WI 53121
Phone (262) 374-5251

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1528577277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 OCONNOR DR",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214269",
            "telephone_number": "262-374-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 OCONNOR DR",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531214269",
            "telephone_number": "262-374-5251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4306 W Solon Rd",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "IL",
            "postal_code": "600719738",
            "country_code": "US",
            "telephone_number": "262-374-5251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAROTTA",
        "first_name": "MARINNA",
        "middle_name": "MIL",
        "name_prefix": "Mrs.",
        "credential": "LPC LCPC CSAC PMH-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16192131",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.011635",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "6576125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "6576-125",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL PROFESSIONAL COUNSELOR",
            "identifier": "180.011635",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhorn, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.