Individual provider Active NPI

Gina Marinello-McEntire, LPC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1730826231
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-22718 Issued in AZ
Practice address
750 E Thunderbird Rd # 1-3
Phoenix, AZ 85022-5306
Phone
(602) 230-7373
Fax
(602) 218-6383
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LAC-19853 AZ
Professional Counselor 101YP2500X LPC-22718 AZ Primary

Addresses

Primary practice location

750 E Thunderbird Rd # 1-3
Phoenix, AZ 85022-5306

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20240328001388 AZ Practitioner - Mental Health Counselor 3678910429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Denova Collaborative Health, LLCGroup PAC ID 2466437736, 141 clinicians

Practice addresses (Care Compare)

750 E Thunderbird Rd
1 3
Phoenix, AZ 85022-5306
Phone (602) 230-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-19853AZMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Denova Collaborative Health, LLC CurrentSince Mar 14, 2024 Accepting new patients
Denova Collaborative Health, LLC CurrentSince Mar 14, 2024 Accepting new patients
Denova Collaborative Health, LLC Current Accepting new patients

Locations

2204 S Dobson Rd
Ste 102
Mesa, AZ 85202

2120 W Guadalupe Rd
Ste 6
Mesa, AZ 85202
Phone (480) 629-8577

750 E Thunderbird Rd
#13
Phoenix, AZ 85022

3101 N Central Ave
Ste 550
Phoenix, AZ 85012

750 E Thunderbird Rd
Ste 1
Phoenix, AZ 85022
Phone (602) 942-8512

750 E Thunderbird Rd
Ste 13
Phoenix, AZ 85022
Phone (602) 682-7455

3101 N Central Ave
Ste 500
Phoenix, AZ 85012

3620 N 3rd St
Phoenix, AZ 85012
Phone (602) 329-8250

3033 N Central Ave
Ste 700
Phoenix, AZ 85012
Phone (602) 281-7289

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1730826231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 N CENTRAL AVE STE 550",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122635",
            "telephone_number": "602-230-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E THUNDERBIRD RD # 1-3",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225306",
            "telephone_number": "602-230-7373",
            "fax_number": "602-218-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINELLO-MCENTIRE",
        "first_name": "GINA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LAC-19853",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-22718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.