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MR. MARVIN THEODORE
NPI 1700393527
Counselor - Addiction (Substance Use Disorder) in Staten Island, NY

Active since January 02, 2018
263 PORT RICHMOND AVE, STATEN ISLAND, NY 10302(718) 981-8117 Get Directions Write a Review

NPPES record last updated: January 2, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Marvin Theodore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MARVIN THEODORE (NPI 1700393527) is an individual addiction (substance use disorder) provider in Staten Island, New York, licensed in New York (33621) and active in the NPI registry since January 2018.

NPPES Registry Identity

NPI1700393527
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameMR. MARVIN THEODORE
Location Address263 PORT RICHMOND AVEStaten Island, NY 10302-1704
Mailing Address263 Port Richmond AveStaten Island, NY 10302-1704 · (718) 981-8117
Phone(718) 981-8117
Sole ProprietorYes
Enumeration DateJanuary 2, 2018
✔ NPI 1700393527 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in NY · 33621
263 PORT RICHMOND AVE, Staten Island, NY 10302
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PROF. JOSEPHINE MARY SHEA LMHC,CRC,CASAC
Counselor (Mental Health)
263 PORT RICHMOND AVE
STATEN ISLAND, NY 10302
Richmond County (718) 981-8117
MR. RALPH M RIVERA CASACT
Counselor (Addiction (Substance Use Disorder))
263 PORT RICHMOND AVE
STATEN ISLAND, NY 10302
Richmond County (718) 981-8117

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Marvin Theodore's NPI number?

The NPI number for Marvin Theodore is 1700393527. It was assigned to this individual provider in the NPPES registry on January 2, 2018.

Where is Marvin Theodore located?

Marvin Theodore practices at 263 Port Richmond Ave, Staten Island, NY 10302. The listed phone number is (718) 981-8117.

What is Marvin Theodore's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Marvin Theodore was last updated on January 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.