Christa Liseno, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

019161-1 Issued in NY

Practice address

3180 West St
Canandaigua, NY 14424-1722

Phone

(585) 394-1442

Fax

(585) 394-1257

NPI assigned

Jul 25, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Christa Dinolfo Former name

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Staten Island, NY
  • NPI 1750469912
  Medicare reassignment

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

{
    "created_epoch": "1311552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555977600000",
    "number": "1942588058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241722",
            "telephone_number": "585-394-1442",
            "fax_number": "585-394-1257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WEST ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241722",
            "telephone_number": "585-394-1442",
            "fax_number": "585-394-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENO",
        "first_name": "CHRISTA",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-25",
        "last_updated": "2019-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019161-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTA",
            "last_name": "DINOLFO",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline C.M. Lincoln, LCSW
• Laura Ann Lindsay, PA
• John Clayton Link, L.M.T.
• Whitney Justine Lipp, M.S., OTR/L
• Lisa Gordner LCSW PLLC
• Susan Theresa Lisi
• Michael Loeb, MD
• Bernard A Logan Jr., PA
• Jonathan Logan, M.D.
• Bruce Long, LMSW

• Clinical Psychologist in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.