Gina M Canen, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Beacon, NY
NPI 1801064282 · NPPES record last updated Mar 9, 2025
Key facts
- NPI
- 1801064282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- F406391-01 (NY)
- Practice address
- 41 Verplanck Ave
Beacon, NY 12508-1844 - Phone
- (908) 798-0326
- NPI assigned
- Feb 19, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250116003528 | NY | Order and Referring Only - Nurse Practitioner | 2163950221 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F406391-01 | NY | MD | Psychiatric/Mental Health Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | F406391-01 | NY | Yes |
Addresses
Primary practice location
41 Verplanck Ave
Beacon, NY 12508-1844
Mailing address
41 Verplanck Ave
Beacon, NY 12508-1844
Phone (718) 828-2666
Other providers in Beacon, NY
- Victoria Darlene Britton
- Hannah L Brooks
- Kara Bucci
- Alvin Cabrillas
- Steven Callaghan
- Gina Cappo
- Carefullmd Beacon Inc
- Kirsten Carillo
- Elizabeth Casasnovas-Calderon
- Central Orange Physician Services PA
All providers in Beacon, NY · Psychiatric/Mental Health Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.