Individual provider Active NPI

Thomas Anthony Susinno-Eadicicco, LMHC

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1306727474
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01557401 Issued in NY
Practice address
200 Evergreen Ave
Staten Island, NY 10305-2322
Phone
(718) 666-5927
NPI assigned
Sep 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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 01557401 NY Primary

Addresses

Primary practice location

200 Evergreen Ave
Staten Island, NY 10305-2322

Mailing address

200 Evergreen Ave
Staten Island, NY 10305-2322

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
01557401NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1757289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1306727474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 EVERGREEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EVERGREEN AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103052322",
            "telephone_number": "718-666-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSINNO-EADICICCO",
        "first_name": "THOMAS",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "01557401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2025; 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.