Kirsanoff Psychotherapy PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801085078 Issued in MI

Legal business name

KIRSANOFF PSYCHOTHERAPY PLLC

Practice address

3083 Coolidge Hwy
Berkley, MI 48072-3523

Phone

(248) 850-1546

Fax

(248) 850-1545

NPI assigned

Jun 5, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Lynelle Marie Kirsanoff, LMSW

Title

Owner/Psychotherapist

Phone

(248) 850-1546

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1710248810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3083 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723523",
            "telephone_number": "248-850-1546",
            "fax_number": "248-850-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3083 COOLIDGE HWY",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480723523",
            "telephone_number": "248-850-1546",
            "fax_number": "248-850-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIRSANOFF PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "KIRSANOFF",
        "authorized_official_first_name": "LYNELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "248-850-1546",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Deborah Lou Kobayashi, LMSW
• Armen A Korkigian, DO

• Clinical Social Worker in Berkley, MI
• Providers in Berkley, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.