NPIMap

Organization Active NPI

Canino LCSW Psychotherapy PC

  • Health Maintenance Organization
  • Brooklyn, NY
National Provider Identifier
1225220072
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
069434 Issued in NY
Legal business name
CANINO LCSW PSYCHOTHERAPY PC
Practice address
70 Washington St
Suite 3C
Brooklyn, NY 11201-1442
Phone
(917) 543-1011
Fax
(718) 852-6921
NPI assigned
Aug 15, 2007
Last updated
Feb 20, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Michael F Canino, LCSWNPI 1891850517
Title
Owner
Phone
(917) 543-1011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 069434 NY Primary

Addresses

Primary practice location

70 Washington St
Suite 3C
Brooklyn, NY 11201-1442

Mailing address

70 Washington St
Suite 3C
Brooklyn, NY 11201-1442
Phone (917) 543-1011

Other identifiers 3

IdentifierTypeStateIssuer
P3369526OtherNYOXFORD
545926OtherNYVALUE OPTIONS
7349398OtherNYGHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080407000697 NY Part B Supplier - Clinic/Group Practice 2961589577 Receives reassigned benefits from 36 practitioners
Practice locations: Brooklyn, NY; Staten Island, NY

National Provider Directory

National Provider Directory

Locations

68 Jay St
Ste 311
Brooklyn, NY 11201
Phone (347) 560-8591

68 Jay St
Ste 620
Brooklyn, NY 11201
Phone (646) 362-9382

1082 Victory Blvd
Staten Island, NY 10301
Phone (718) 815-3500

Practitioners & affiliated clinicians

Practitioners 69

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 69

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1225220072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "SUITE 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011442",
            "telephone_number": "917-543-1011",
            "fax_number": "718-852-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "SUITE 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011442",
            "telephone_number": "917-543-1011",
            "fax_number": "718-852-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANINO LCSW PSYCHOTHERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "CANINO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-543-1011",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NY",
            "license": "069434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3369526",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "545926",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7349398",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.