Marilyn Elllen Kovtunovich, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

490 Issued in OR

Practice address

320 E Main St
Suite 203
Ashland, OR 97520-6800

Phone

(541) 482-1278

NPI assigned

Sep 17, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Marilyn Ellen Viccaro Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Allan Weisbard L.C.S.W. LLC

  • Clinical Social Worker
  • Ashland, OR
  • NPI 1467741595
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1720185408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975200001",
            "telephone_number": "541-482-1278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 E MAIN ST",
            "address_2": "SUITE 203",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975206800",
            "telephone_number": "541-482-1278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVTUNOVICH",
        "first_name": "MARILYN",
        "middle_name": "ELLLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "VICCARO",
            "middle_name": "ELLEN",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carole Taylor Kohn, LPC
• Kolpia Counseling Service
• Kolpia Counseling Services Inc
• Debra L. Koutnik, MD
• Chris Kovash, LPC
• Sharon Kraus, L.AC.
• James Burnell Krick, PHARM.D.
• Kristen M Engstrom Crna LLC
• Jenny Kuehnle, LMT
• Karin B Kuhl, MD

• Clinical Social Worker in Ashland, OR
• Providers in Ashland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.