Shanoa Dione Praay

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6301016676 Issued in MI

Practice address

4845 Snyder Ave
Fremont, MI 49412-8573

Phone

(231) 924-6920

NPI assigned

Aug 2, 2016

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Regional Psychology and Wellness, LLC

  • Counseling Psychologist
  • Fremont, MI
  • NPI 1154894376
  NPD (past) Authorized official

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1306399746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4845 SNYDER AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128573",
            "telephone_number": "231-924-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 SNYDER AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494128573",
            "telephone_number": "231-924-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAAY",
        "first_name": "SHANOA",
        "middle_name": "DIONE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301016676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6301016676",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Fremont, MI
• Providers in Fremont, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.