Michelle L Marino, CRNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

SP023522 Issued in PA

Practice address

130 N. McKean St.
Suite 204
Kittanning, PA 16201

Phone

(724) 302-5969

Fax

(724) 204-1946

NPI assigned

Dec 15, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Persoma P.C.

  • Mental Health Counselor
  • Monroeville, PA
  • NPI 1790712156

  PA

  Medicare reassignment NPD
• Upmc Community Medicine, Inc

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1558976092

  PA

  Medicare reassignment NPD
• Renewed Outlook Holistic Mental Health and Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Kittanning, PA
  • NPI 1285471383

  Psychiatric/Mental Health

  NPD Authorized official
• Upmc Community Medicine Inc

  • Internal Medicine Physician
  • Wexford, PA
  • NPI 1447378765
  NPD
• The Nexus Group PC

  • Child & Adolescent Psychiatry Physician
  • Pittsburgh, PA
  • NPI 1295225597
  NPD (past)

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

{
    "created_epoch": "1323907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728172800000",
    "number": "1942579289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10526",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152350526",
            "telephone_number": "724-302-5969",
            "fax_number": "724-204-1946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N. MCKEAN ST.",
            "address_2": "SUITE 204",
            "city": "KITTANNING",
            "state": "PA",
            "postal_code": "16201",
            "telephone_number": "724-302-5969",
            "fax_number": "724-204-1946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3910 Caughey Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165064098",
            "country_code": "US",
            "telephone_number": "724-302-5969",
            "fax_number": "724-204-1946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARINO",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-15",
        "last_updated": "2024-10-06",
        "certification_date": "2024-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP023522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles A Lynn, MD
• Sarah Leona Macklin, M.A.
• Joann Mahlmeister
• Cathy S Malmon, LSW
• Jyothika Mamadgi, M.D
• Michael D. Martin, M.D.
• William Edward Martin, D.D.S.
• John Albert Marty Jr., DPM
• Gregory E Masci, DC
• Lisa A McCay, PH.D.

• All providers in Kittanning, PA
• Psychiatric/Mental Health Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.