Individual provider Active NPI

Michael F Canino, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1891850517
Registry record updated Apr 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069434 Issued in NY
Practice address
70 Washington St Apt 3C
Brooklyn, NY 11201-1443
Phone
(917) 543-1011
Fax
(718) 852-6921
NPI assigned
Dec 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 069434 NY Primary

Addresses

Primary practice location

70 Washington St Apt 3C
Brooklyn, NY 11201-1443

Mailing address

70 Washington St
Suite 3C
Brooklyn, NY 11201-1442
Phone (917) 543-1011

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
I20071022000312 NY Practitioner - Clinical Social Worker 6002902012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Fordham University School of Medicine, 1999
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Canino LCSW Psychotherapy, PCGroup PAC ID 2961589577, 15 clinicians

Practice addresses (Care Compare)

70 Washington St
Apt 3C
Brooklyn, NY 11201-1443
Phone (718) 983-8872

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Canino LCSW Psychotherapy PC CurrentSince Oct 1, 2007 Accepting new patients

Locations

68 Jay St
Ste 620
Brooklyn, NY 11201
Phone (646) 362-9382

1082 Victory Blvd
Staten Island, NY 10301
Phone (718) 815-3500

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1891850517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST",
            "address_2": "SUITE 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011442",
            "telephone_number": "917-543-1011",
            "fax_number": "718-852-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WASHINGTON ST APT 3C",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112011443",
            "telephone_number": "917-543-1011",
            "fax_number": "718-852-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANINO",
        "first_name": "MICHAEL",
        "middle_name": "F",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.