Elizabeth Canick, MD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4302 Issued in MA

Practice address

77 Warren St
Brighton, MA 02135-3601

Phone

(617) 562-5567

Fax

(617) 562-5564

NPI assigned

Sep 13, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 20, 2024 through Feb 20, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

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.

• Caritas St. Elizabeth'S Medical Center

  • Specialist
  • Brighton, MA
  • NPI 1770574527
  NPD (past)
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285738708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN ST FL 3",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5485",
            "fax_number": "617-562-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 WARREN ST",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "021353601",
            "telephone_number": "617-562-5567",
            "fax_number": "617-562-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANICK",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "4302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Campagna, MA
• Jodie Campbell, LCSW
• Raquel Campos
• Abrianna R Canady
• Hai Cang
• Susan Cann, NP
• Cap Anesthesia, PC
• Cap Anesthesia, PC
• Maria Christina Victoria Capistrano, MD
• Lisa Rachael Capra, M.D.

• Psychologist in Brighton, MA
• Providers in Brighton, MA by specialty
• Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.