Erica L Marino, PH.D. INTERN

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PI039 Issued in NV

Practice address

3017 W Charleston Blvd Ste 54
Las Vegas, NV 89102-1927

Phone

(702) 637-5198

NPI assigned

Jan 10, 2012

Last updated

Oct 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other names 1

• Erica Marino-Blanchard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ayurveda Wellness LTD

  • Clinical Psychologist
  • Las Vegas, NV
  • NPI 1831912013

  Addiction (Substance Use Disorder)

  NPD Authorized official
• Specialized Alternatives for Families and Youth of Nevada, Inc.

  • Foster Care Agency
  • Las Vegas, NV
  • NPI 1841883386
  NPD (past)
• Specialized Alternatives for Families and Youth of Nevada, Inc.

  dba SAFY of Nevada

  • Adolescent and Children Mental Health Clinic/Center
  • Las Vegas, NV
  • NPI 1962595348

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1326153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1962772780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 54",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 W CHARLESTON BLVD STE 54",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021927",
            "telephone_number": "702-637-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINO",
        "first_name": "ERICA",
        "middle_name": "L",
        "credential": "PH.D. INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-10",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "PI039",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NV",
            "license": "PI039",
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NV",
            "license": "PI039",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0004X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health",
            "state": "NV",
            "license": "PI039",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PI039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "MARINO-BLANCHARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Marinch, DPT
• Sherline Marine
• Lazaro Rene Marinez Marquez
• Allen Marino, MD
• Anthony Amin Marino, DC
• Erin Marino
• Lillian I Marino
• Sabrina Marino
• Carisa N Marinucci
• Mario F. Tarquino M.D. Inc.

• Clinical Psychologist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.