Healthcare Provider Details

I. General information

NPI: 1346365012
Provider Name (Legal Business Name): GEORGE CHARLES MARINAKIS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 WOBURN ST THE ACADEMY NORTH
READING MA
01867
US

IV. Provider business mailing address

417 SUMMER AVE
READING MA
01867
US

V. Phone/Fax

Practice location:
  • Phone: 781-942-9277
  • Fax: 781-944-6535
Mailing address:
  • Phone: 781-944-3451
  • Fax: 781-944-9310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4880
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number4880
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code103TP2701X
TaxonomyGroup Psychotherapy Psychologist
License Number4880
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: