Individual provider Active NPI

Koren Ganas, PSYD

  • Psychologist
  • Evansville, IN
National Provider Identifier
1346680121
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
20042694A Issued in IN
Practice address
415 W Columbia St Ste 110
Evansville, IN 47710-1656
Phone
(812) 450-6200
Fax
(812) 450-6202
NPI assigned
Jun 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 20042694A IN Primary

Addresses

Primary practice location

415 W Columbia St Ste 110
Evansville, IN 47710-1656

Mailing address

PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-3363

Other names 1

  • Koren Ganas - Wright Former name

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
20042694AINMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1346680121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3407",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477333407",
            "telephone_number": "812-450-3363",
            "fax_number": "812-450-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 W COLUMBIA ST STE 110",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101656",
            "telephone_number": "812-450-6200",
            "fax_number": "812-450-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANAS",
        "first_name": "KOREN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042694A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KOREN",
            "last_name": "GANAS - WRIGHT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.