Individual provider Active NPI

Marianne Key-Carniak

  • Psychologist
  • Troy, MI
National Provider Identifier
1023583697
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6301014480 Issued in MI
Practice address
1700 W Big Beaver Rd Ste 200
Troy, MI 48084-3524
Phone
(248) 420-6742
NPI assigned
Oct 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6301014480 MI Primary

Addresses

Primary practice location

1700 W Big Beaver Rd Ste 200
Troy, MI 48084-3524

Mailing address

150 Lange Dr
Troy, MI 48098-4667
Phone (248) 420-6742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6301014480MIMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1023583697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 LANGE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480984667",
            "telephone_number": "248-420-6742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 W BIG BEAVER RD STE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843524",
            "telephone_number": "248-420-6742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEY-CARNIAK",
        "first_name": "MARIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301014480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.