Individual provider Active NPI

Elizabeth Janelle Kanagawa, LLPC

  • Professional Counselor
  • Taylor, MI
National Provider Identifier
1689011702
Registry record updated May 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401013636 Issued in MI
Practice address
25507 Ecorse Rd
Taylor, MI 48180-1555
Phone
(313) 292-7640
Fax
(313) 292-9270
NPI assigned
May 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6401013636 MI Primary

Addresses

Primary practice location

25507 Ecorse Rd
Taylor, MI 48180-1555

Mailing address

25507 Ecorse Rd
Taylor, MI 48180-1555
Phone (313) 292-7640

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
6401013636MIMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1369872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369872000000",
    "number": "1689011702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25507 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801555",
            "telephone_number": "313-292-7640",
            "fax_number": "313-292-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25507 ECORSE RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481801555",
            "telephone_number": "313-292-7640",
            "fax_number": "313-292-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANAGAWA",
        "first_name": "ELIZABETH",
        "middle_name": "JANELLE",
        "credential": "LLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-30",
        "last_updated": "2013-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401013636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.