Provider Demographics
NPI:1407922719
Name:TEMKINA, MARINA Z (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARINA
Middle Name:Z
Last Name:TEMKINA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 W 21ST ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3084
Mailing Address - Country:US
Mailing Address - Phone:212-929-0017
Mailing Address - Fax:212-268-2878
Practice Address - Street 1:50 W HAWTHORNE AVE
Practice Address - Street 2:PENINSULA COUNSELING CENTER, INC.
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-6220
Practice Address - Country:US
Practice Address - Phone:516-569-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076331-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical