Individual provider Active NPI

Amy Grace Canton

  • Mental Health Counselor
  • Novato, CA
National Provider Identifier
1821536657
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I88065 Issued in CA
Practice address
411 Alameda del Prado
Novato, CA 94949-6302
Phone
(415) 302-2835
NPI assigned
Jan 31, 2017
Last updated
Jan 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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 I88065 CA Primary

Addresses

Primary practice location

411 Alameda del Prado
Novato, CA 94949-6302

Mailing address

411 Alameda del Prado
Novato, CA 94949-6302
Phone (415) 302-2835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250107003426 CA Practitioner - Marriage and Family Therapist 2567990377 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
County of MarinGroup PAC ID 1153225065, 19 clinicians

Practice addresses (Care Compare)

250 Bon Air Rd
Greenbrae, CA 94904-1702
Phone (415) 499-6835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I88065CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Marin CurrentSince Oct 18, 2024 Accepting new patients
County of Marin CurrentSince Oct 18, 2024 Accepting new patients

Locations

250 Bon Air Rd
Kentfield, CA 94904
Phone (415) 464-1350

3230 Kerner Blvd
San Rafael, CA 94901
Phone (415) 473-6724

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": "1485820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1821536657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 ALAMEDA DEL PRADO",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496302",
            "telephone_number": "415-302-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 ALAMEDA DEL PRADO",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949496302",
            "telephone_number": "415-302-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANTON",
        "first_name": "AMY",
        "middle_name": "GRACE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "I88065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novato, CA

Sources for this page

Verify at the official NPI Registry.