MARINA SPACEK – Mental Health Counselor, NPI 1124653480

MARINA SPACEK is a healthcare provider. based in San diego, California. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 112587 (CA). The NPI Number for MARINA SPACEK is 1124653480

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
MARINA SPACEK
NPI
1124653480
Phone
(619) 398-0355
Address
1260 MORENA BLVD STE 100
Enumeration Date
6 March 2020
Last Update Date
6 March 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6193980355
Graduation Year
2019 (7 years ago)
PAC ID
4688047293
Group Practice PAC ID
6800825332
Professional Enrollment ID
I20230301002921
Address ID
CA921103850SA1260XBLVD301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

Provider Addresses for MARINA SPACEK

  • 1260 MORENA BLVD STE 100

    SAN DIEGO, CA 921103850

    Phone: (619) 398-0355

    Type: Mailing

  • 1202 Morena Blvd Ste 300

    San Diego, CA 921103844

    Phone: (619) 275-0822

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20230301002921IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92110)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800825332View full group profile
NameSpecialtyState
P S Y C H I A T R YCA
Nurse PractitionerCA
P S Y C H I A T R YCA
Marriage And Family TherapistCA
Psychiatry, Family PracticeCA
P S Y C H I A T R YCA
-CA
Clinical Social WorkerCA
P S Y C H I A T R YCA
P S Y C H I A T R YCA

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARINA SPACEK?
MARINA SPACEK — NPI 1124653480 — is the standard way to identify this listing.
Is MARINA SPACEK still practicing?
MARINA SPACEK is currently listed as active in the public NPI registry.
What healthcare role does MARINA SPACEK hold?
Scheduling teams often label MARINA SPACEK under Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What area does MARINA SPACEK serve?
MARINA SPACEK's listing highlights San Diego, California; more addresses can appear in NPPES.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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