NPIMap

Organization Active NPI

Kelly Marino Kelly Marino LCSW

  • Clinical Social Worker
  • Stamford, CT
National Provider Identifier
1851775159
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081517 Issued in CT
Legal business name
KELLY MARINO KELLY MARINO LCSW
Practice address
85 Old Long Ridge Rd
Stamford, CT 06903-1641
Phone
(203) 536-8788
NPI assigned
Jul 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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

Authorized official

Name
Kelly A Marino, LCSW
Title
Owner
Phone
(203) 536-8788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 081517 CT Primary

Addresses

Primary practice location

85 Old Long Ridge Rd
Stamford, CT 06903-1641

Mailing address

85 Old Long Ridge Rd
Stamford, CT 06903-1641
Phone (203) 536-8788

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1851775159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 OLD LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069031641",
            "telephone_number": "203-536-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 OLD LONG RIDGE RD",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069031641",
            "telephone_number": "203-536-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY MARINO KELLY MARINO LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-536-8788",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "081517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.