Connie Proano, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021959 Issued in NY

Practice address

25 Flatbush Ave FL 3
Brooklyn, NY 11217-1101

Phone

(718) 875-1420

Fax

(718) 875-5496

NPI assigned

Mar 15, 2017

Last updated

Mar 15, 2017By the provider in NPPES

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

Other names 1

• Consuelo Proano Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1489536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1427599109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 FLATBUSH AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171101",
            "telephone_number": "718-875-1420",
            "fax_number": "718-875-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 FLATBUSH AVE FL 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112171101",
            "telephone_number": "718-875-1420",
            "fax_number": "718-875-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROANO",
        "first_name": "CONNIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-15",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONSUELO",
            "last_name": "PROANO",
            "credential": "PSY.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.