Kanaan Therapy and Behavioral Health Services, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401012892 Issued in MI

Legal business name

KANAAN THERAPY AND BEHAVIORAL HEALTH SERVICES, LLC

Practice address

816 East Michigan Avenue
Suite 103
Paw Paw, MI 49079-9510

Phone

(269) 815-8168

NPI assigned

May 29, 2017

Organization subpart

No

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

Authorized official

Name

Timothy Adli Kanaan, LPCNPI 1346775269

Title

Owner/Partner

Phone

(269) 815-8168

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paula Renee Kanaan, LMSW

  • Clinical Social Worker
  • Paw Paw, MI
  • NPI 1558608729
  Medicare reassignment NPD
• Timothy Adli Kanaan, LPC

  • Mental Health Counselor
  • Paw Paw, MI
  • NPI 1346775269
  NPD Authorized official

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

{
    "created_epoch": "1496016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1174051619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 EAST MICHIGAN AVENUE",
            "address_2": "SUITE 103",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490799510",
            "telephone_number": "269-815-8168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 EAST MICHIGAN AVENUE",
            "address_2": "SUITE 103",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490799510",
            "telephone_number": "269-815-8168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANAAN THERAPY AND BEHAVIORAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-29",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "KANAAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ADLI",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "269-815-8168",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401012892",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092614",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marlesa Maria Johnson, DPT
• Meadow Alise Johnson
• Roderick Lynn Johnson, M.A.
• Andrina Jordan, LPC
• Joseph Dental Group
• Paula Renee Kanaan, LMSW
• Timothy Adli Kanaan, LPC
• Wade Addam Kapik, LLP
• John W Kavanaugh Jr., MD
• Kaitlyn Marie Keen, LMSW

• Mental Health Counselor in Paw Paw, MI
• Providers in Paw Paw, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.