Individual provider Active NPI

John Vito Fasano, LMHC

  • Mental Health Counselor
  • New City, NY
National Provider Identifier
1811714793
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015130 Issued in NY
Practice address
52 Shetland Dr
New City, NY 10956-4635
Phone
(845) 270-4749
NPI assigned
Sep 23, 2024
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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 015130 NY Primary

Addresses

Primary practice location

52 Shetland Dr
New City, NY 10956-4635

Mailing address

52 Shetland Dr
New City, NY 10956-4635
Phone (845) 270-4749

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251209001840 NY Practitioner - Mental Health Counselor 9537653449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Senior Psychological Services, PCGroup PAC ID 8022905314, 227 clinicians

Practice addresses (Care Compare)

300 Cadman PLZ W
Brooklyn, NY 11201-3211
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015130NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC CurrentSince Nov 17, 2025 Accepting new patients
Knapp Street Psychiatry, PC CurrentSince Nov 17, 2025 Accepting new patients

Locations

1915 Ocean Ave
Brooklyn, NY 11230
Phone (718) 258-7700

2433 Knapp St
Ste 306
Brooklyn, NY 11235

250 Beach 17th St
Far Rockaway, NY 11691
Phone (516) 670-0212

209 Beach 125th St
Rockaway Park, NY 11694
Phone (516) 721-7625

135 Vanderbilt Ave
Staten Island, NY 10304
Phone (718) 420-1934

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1811714793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 SHETLAND DR",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564635",
            "telephone_number": "845-270-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 SHETLAND DR",
            "city": "NEW CITY",
            "state": "NY",
            "postal_code": "109564635",
            "telephone_number": "845-270-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO",
        "first_name": "JOHN",
        "middle_name": "VITO",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New City, NY

Sources for this page

Verify at the official NPI Registry.