Individual provider Active NPI

Colleen P Carini, LMSW

  • Social Worker
  • Riverhead, NY
National Provider Identifier
1083324560
Registry record updated Nov 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
099169-01 Issued in NY
Practice address
579 Pleasure Dr
Riverhead, NY 11901-4921
Phone
(631) 494-8406
NPI assigned
Nov 25, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X 099169-01 NY Primary

Addresses

Primary practice location

579 Pleasure Dr
Riverhead, NY 11901-4921

Mailing address

579 Pleasure Dr
Riverhead, NY 11901-4921
Phone (631) 494-8406

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
099169-01NYMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1083324560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 PLEASURE DR",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014921",
            "telephone_number": "631-494-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 PLEASURE DR",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119014921",
            "telephone_number": "631-494-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARINI",
        "first_name": "COLLEEN",
        "middle_name": "P",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NY",
            "license": "099169-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.