Individual provider Active NPI

Mary T. Marino, PHD

  • Professional Counselor
  • Holbrook, NY
National Provider Identifier
1548758840
Registry record updated Apr 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
233 Union Ave Ste 205
Holbrook, NY 11741-1821
Phone
(631) 942-4486
NPI assigned
Apr 23, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

233 Union Ave Ste 205
Holbrook, NY 11741-1821

Mailing address

233 Union Ave Ste 205
Holbrook, NY 11741-1821
Phone (631) 942-4486

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524528000000",
    "number": "1548758840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 UNION AVE STE 205",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411821",
            "telephone_number": "631-942-4486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 UNION AVE STE 205",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117411821",
            "telephone_number": "631-942-4486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "MARY",
        "middle_name": "T.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2018; 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.