MEDICARE: CHRISTINE MARINO COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1265252563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE MARINO COUNSELING LLC

Provider Business Mailing Address
First Line	:	5914 NEWPORT VILLAGE WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7325
Country	:	US
Telephone Number	:	561-713-6180
Fax Number	:

Provider Business Practice Location Address
First Line	:	5914 NEWPORT VILLAGE WAY
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-7325
Country	:	US
Telephone Number	:	561-713-6180
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	CHRISTINE MARIE MARINO
Credential	:	LMHC
Telephone Number	:	561-713-6180

Provider Enumeration Date	:	10/12/2024
Last Update Date	:	10/12/2024

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