Marc G Denonn

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CRPA-6711 Issued in NY

Practice address

3026 Maine Ave
Medford, NY 11763-1936

Phone

(631) 742-2849

NPI assigned

Dec 5, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Outreach Development Corporation

  • Addiction (Substance Use Disorder) Counselor
  • Richmond Hill, NY
  • NPI 1083717326
  NPD (past)

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

{
    "created_epoch": "1764892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764892800000",
    "number": "1609739770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3026 MAINE AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631936",
            "telephone_number": "631-742-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3026 MAINE AVE",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631936",
            "telephone_number": "631-742-2849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Farber Dr",
            "address_purpose": "LOCATION",
            "city": "Bellport",
            "state": "NY",
            "postal_code": "117131500",
            "country_code": "US",
            "telephone_number": "631-286-0700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENONN",
        "first_name": "MARC",
        "middle_name": "G",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-05",
        "last_updated": "2025-12-05",
        "certification_date": "2025-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NY",
            "license": "CRPA-6711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DC Transporters Inc
• Heather Decarlo, LPN
• Marie Deguerre
• Amy Delgado, LMHC
• Jaime Dellipizzi
• Dyshonia Louise Dent, LPN
• Samantha Rae Desantis, LMSW
• Eileen Marie Desimone, MS, BS IN EDUCATION
• John Desimone
• Developmental Disiabilities Institute

• Peer Specialist in Medford, NY
• Providers in Medford, NY by specialty
• Peer Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2025; 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.