Individual provider Active NPI

Marion Antrenette Denefield, LPCC

  • Mental Health Counselor
  • Akron, OH
National Provider Identifier
1609340082
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2404090 Issued in OH
Practice address
838 Coburn St
Akron, OH 44311-1459
Phone
(330) 434-4141
Fax
(330) 208-2136
NPI assigned
Jan 18, 2019
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDCA.170397 OH
Mental Health Counselor 101YM0800X E.2404090 OH Primary

Addresses

Primary practice location

838 Coburn St
Akron, OH 44311-1459

Mailing address

1368 Shanabrook Dr
Akron, OH 44313-5734
Phone (330) 338-6352

Other identifiers 1

IdentifierTypeStateIssuer
1609340082OtherOHNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240327000202 OH Practitioner - Mental Health Counselor 5294186664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Group practices
Center for Revolutionary Relationships LLCGroup PAC ID 2860828902, 2 clinicians

Practice addresses (Care Compare)

3200 W Market St
Suite 101
Fairlawn, OH 44333-3324
Phone (330) 459-6743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CDCA.170397OHMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Akron General Medical Center CurrentSince Sep 6, 2024 Accepting new patients
Center for Revolutionary Relationships LLC CurrentSince Feb 15, 2024 Accepting new patients
Akron General Medical Center CurrentSince Sep 6, 2024 Accepting new patients
Community Drug Board, Inc Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

3200 W Market St
Ste 101
Fairlawn, OH 44333
Phone (330) 459-6743

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1609340082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1368 SHANABROOK DR",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443135734",
            "telephone_number": "330-338-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 COBURN ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111459",
            "telephone_number": "330-434-4141",
            "fax_number": "330-208-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENEFIELD",
        "first_name": "MARION",
        "middle_name": "ANTRENETTE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.170397",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2404090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "1609340082",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.