Healthcare Provider Details

I. General information

NPI: 1194080549
Provider Name (Legal Business Name): THOMAS JOSEPH MARINAK JR. LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 FAIRVIEW ST
SIMSBURY CT
06070-2126
US

IV. Provider business mailing address

15 FAIRVIEW ST
SIMSBURY CT
06070-2126
US

V. Phone/Fax

Practice location:
  • Phone: 860-805-7470
  • Fax:
Mailing address:
  • Phone: 860-805-7470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001425
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: