Active NPI
Philip Richard Granish, LLP
- Psychologist
- Kalamazoo, MI
National Provider Identifier
1700324415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6361006461
- Practice address
- 4341 S. Westnedge
Suite 1103
Kalamazoo, MI 49008 - Phone
- (269) 982-3832
- Fax
- (269) 281-0351
- NPI assigned
- Feb 2, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6361006461 | MI | Primary |
Addresses
Primary practice location
4341 S. Westnedge
Suite 1103
Kalamazoo, MI 49008
Mailing address
4384 Laurel Drive
Saint Joseph, MI 49085
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43191 | Other | MI | MICHIGAN DEPARTMENT OF CORRECTIONS PROVIDER ID NUMBER |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6361006461 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Therapy & Development Centers Inc | Past | Accepting new patients | |
| Richard Kneip, PH.D., P.C. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Counselor
- Saint Joseph, MI
- NPI 1295916187
-
- Community/Behavioral Health Agency
- Clarkston, MI
- NPI 1679739700
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677110400000",
"number": "1700324415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4384 LAUREL DRIVE",
"city": "SAINT JOSEPH",
"state": "MI",
"postal_code": "49085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4341 S. WESTNEDGE",
"address_2": "SUITE 1103",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "49008",
"telephone_number": "269-982-3832",
"fax_number": "269-281-0351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANISH",
"first_name": "PHILIP",
"middle_name": "RICHARD",
"credential": "LLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-02-02",
"last_updated": "2023-02-23",
"certification_date": "2023-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6361006461",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MICHIGAN DEPARTMENT OF CORRECTIONS PROVIDER ID NUMBER",
"identifier": "43191",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kalamazoo, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.