Individual provider Active NPI

David Fortner Croft-Ogawa, LMHC

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1245870716
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010085 Issued in NY
Practice address
160 Broadway RM 600
New York, NY 10038-4217
Phone
(917) 485-1483
NPI assigned
Jan 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 010085 NY Primary

Addresses

Primary practice location

160 Broadway RM 600
New York, NY 10038-4217

Mailing address

4739 44TH St Apt 2F
Woodside, NY 11377-6324
Phone (917) 485-1483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903001265 NY Practitioner - Mental Health Counselor 2567901663 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010085NYMDOptician

Practice roles

OrganizationSpecialtyStatusNew patients
Canino LCSW Psychotherapy PC CurrentSince Jul 1, 2024 Accepting new patients

Locations

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1245870716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4739 44TH ST APT 2F",
            "city": "WOODSIDE",
            "state": "NY",
            "postal_code": "113776324",
            "telephone_number": "917-485-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BROADWAY RM 600",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384217",
            "telephone_number": "917-485-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFT-OGAWA",
        "first_name": "DAVID",
        "middle_name": "FORTNER",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.