Individual provider Active NPI

Jeffrey Kiewhon Canady, CASAC-T

  • Addiction (Substance Use Disorder) Counselor
  • New York, NY
National Provider Identifier
1659862738
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
34585 Issued in NY
Practice address
1369 Broadway
New York, NY 10018-7200
Phone
(212) 268-8830
Fax
(212) 947-2424
NPI assigned
May 23, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 34585 NY Primary

Addresses

Primary practice location

1369 Broadway
New York, NY 10018-7200

Mailing address

2698 8TH Ave
New York, NY 10030-1219
Phone (347) 583-0718

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
34585NYMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1659862738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2698 8TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100301219",
            "telephone_number": "347-583-0718",
            "fax_number": "212-947-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1369 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100187200",
            "telephone_number": "212-268-8830",
            "fax_number": "212-947-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADY",
        "first_name": "JEFFREY",
        "middle_name": "KIEWHON",
        "name_prefix": "Mr.",
        "credential": "CASAC-T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "34585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.