Kelly Melissa Marciniak

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-19-105378 Issued in MD

Practice address

4 Chelmsford CT
Middle River, MD 21220-3672

Phone

(443) 838-8636

NPI assigned

Nov 10, 2019

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

• Mrs. Kelly Melissa Dotterweich Former name

Medicare fee-for-service enrollment

Enrolled in MD

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

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Rosedale, MD
  • NPI 1053733378
  Medicare reassignment NPD
• Thrive Behavioral Health, LLC

  • Community/Behavioral Health Agency
  • Silver Spring, MD
  • NPI 1306396163
  NPD

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

{
    "created_epoch": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772496000000",
    "number": "1831734235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CHELMSFORD CT",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203672",
            "telephone_number": "443-838-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CHELMSFORD CT",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203672",
            "telephone_number": "443-838-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCINIAK",
        "first_name": "KELLY",
        "middle_name": "MELISSA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-10",
        "last_updated": "2026-03-03",
        "certification_date": "2026-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MD",
            "license": "RBT-19-105378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "DOTTERWEICH",
            "middle_name": "MELISSA",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Antonia O F L Maccormack
• Elizabeth Mary Mackey, CRNA
• Suhas Madhiraju, MD
• Malik Home Care LLC
• Manifest Wellness Services LLC (Manifest Weight Loss: Lose Weight, Love Life, No Restrictions.)
• Charles B Marek Jr., MD
• Tiffany Elizabeth Mark
• Paul Martins
• Maryland CVS Pharmacy LLC (CVS Pharmacy #17086)
• Maggie Matassa

• Behavior Technician in Middle River, MD
• Providers in Middle River, MD by specialty
• Behavior Technician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.