Mariena Star Joy, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L10767 Issued in OR

Practice address

137 Hall Ave
Coos Bay, OR 97420-1519

Phone

(541) 229-7879

NPI assigned

Jan 13, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Gail Marie Small Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Brainbow Forge

  • Clinical Social Worker
  • Coos Bay, OR
  • NPI 1659119030
  NPD Authorized official
• Out of the Rain Counseling Solutions LLC

  • Clinical Social Worker
  • Coos Bay, OR
  • NPI 1033875711
  NPD

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701475200000",
    "number": "1912363441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HALL AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201519",
            "telephone_number": "541-229-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HALL AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201519",
            "telephone_number": "541-229-7879"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1766 Milligan Ave",
            "address_purpose": "LOCATION",
            "city": "Coos Bay",
            "state": "OR",
            "postal_code": "974202926",
            "country_code": "US",
            "telephone_number": "541-435-1407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOY",
        "first_name": "MARIENA",
        "middle_name": "STAR",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L10767",
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500740402",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GAIL",
            "last_name": "SMALL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandria Izora Jones, DENTAL THERAPY
• Douglas A Jones, PHYSICAL THERAPIST
• Kayce Jones
• Kelly Alleen Jones
• Ryan Jones, PA
• Jsi LLC (RainDance Laundry & Diaper Services, LLC)
• Amy C Justman, LPN
• Megan Kalina
• Victoria Kalmykova, RN
• Chery Denise Kandra Smith, LPN

• Clinical Social Worker in Coos Bay, OR
• Providers in Coos Bay, 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 Dec 2, 2023; 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.