Timothy Adli Kanaan, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401012892 Issued in MI

Practice address

816 E Michigan Ave Ste 103
Paw Paw, MI 49079

Phone

(269) 501-5829

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kalamazoo County Community Mental Health AuthorityGroup PAC ID 5890730337, 38 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kalamazoo County Community Mental Health Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Kalamazoo, MI
  • NPI 1710066253
  Medicare reassignment Care Compare group NPD
• Kanaan Therapy and Behavioral Health Services, LLC

  • Mental Health Counselor
  • Paw Paw, MI
  • NPI 1174051619
  NPD Authorized official
• Kalamazoo County Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Kalamazoo, MI
  • NPI 1477225506
  NPD

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717804800000",
    "number": "1346775269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49324 CHURCHILL ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718910",
            "telephone_number": "269-501-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 E MICHIGAN AVE STE 103",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "49079",
            "telephone_number": "269-501-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAAN",
        "first_name": "TIMOTHY",
        "middle_name": "ADLI",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2024-06-08",
        "certification_date": "2024-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401012892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roderick Lynn Johnson, M.A.
• Andrina Jordan, LPC
• Joseph Dental Group
• Kanaan Therapy and Behavioral Health Services, LLC
• Paula Renee Kanaan, LMSW
• Wade Addam Kapik, LLP
• John W Kavanaugh Jr., MD
• Kaitlyn Marie Keen, LMSW
• Stacy Michelle Kelemen
• Kay Keller

• 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 Jun 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.