Michael Cancilliere, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MHC00253 Issued in RI

Practice address

1070 Main St
Pawtucket, RI 02860-4847

Phone

(401) 727-6413

NPI assigned

Jun 25, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Providence Center Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Providence, RI
  • NPI 1104847946

  Mental Health

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 26, 2007.

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1225064751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 MAIN ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604847",
            "telephone_number": "401-727-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCILLIERE",
        "first_name": "MICHAEL",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC00253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MC57460",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "29719-0",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "412738",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "62-29029",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Campanile, MD
• Scott Michael Campbell
• Hannah Camplin, RN
• Sandra Carolina Campusano, CPE, CPD
• Corey Canady
• Anthony Joseph Cannistra, MD
• Lauralyn B. Cannistra, MD
• Kiara Marie Capaldi, DC
• Elizabeth A Cappalli, RD, LDN, CDE,CDOE
• Mikaela Caracciolo, DPT

• All providers in Pawtucket, RI
• Mental Health Counselor in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.