Active NPI
M Kay Hannah, PHD LLP
- Clinical Psychologist
- Grand Rapids, MI
National Provider Identifier
1336119379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301011042
- Practice address
- 3330 Claystone St SE
Grand Rapids, MI 49546-7716 - Phone
- (616) 942-8060
- Fax
- (616) 942-6690
- NPI assigned
- Jan 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301011042 | MI | Primary |
Addresses
Primary practice location
3330 Claystone St SE
Grand Rapids, MI 49546-7716
Mailing address
PO Box 30516
Dept 6065
Lansing, MI 48909-8016
Phone (616) 532-8000
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011042 | MI | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Claystone Clinical Associates PLC | Clinical | Past | Accepting new patients |
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": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1336119379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30516",
"address_2": "DEPT 6065",
"city": "LANSING",
"state": "MI",
"postal_code": "489098016",
"telephone_number": "616-532-8000",
"fax_number": "616-532-7230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 CLAYSTONE ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495467716",
"telephone_number": "616-942-8060",
"fax_number": "616-942-6690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANNAH",
"first_name": "M KAY",
"credential": "PHD LLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-24",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301011042",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.