Individual provider Active NPI

Nicole Danielle Kanke, LMFT

  • Marriage & Family Therapist
  • Westlake Village, CA
National Provider Identifier
1396299020
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94241 Issued in CA
Practice address
5743 Corsa Ave
Suite 112
Westlake Village, CA 91362-4027
Phone
(805) 218-5870
NPI assigned
Aug 10, 2016
Last updated
Aug 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 94241 CA Primary

Addresses

Primary practice location

5743 Corsa Ave
Suite 112
Westlake Village, CA 91362-4027

Mailing address

5743 Corsa Ave
Suite 112
Westlake Village, CA 91362-4027
Phone (805) 218-5870

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

State licenses

LicenseStateTypeSpecialty
94241CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470787200000",
    "number": "1396299020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5743 CORSA AVE",
            "address_2": "SUITE 112",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624027",
            "telephone_number": "805-218-5870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5743 CORSA AVE",
            "address_2": "SUITE 112",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913624027",
            "telephone_number": "805-218-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANKE",
        "first_name": "NICOLE",
        "middle_name": "DANIELLE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-10",
        "last_updated": "2016-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.