Individual provider Active NPI

Coryanna L Ku, LPC, NCC

  • Professional Counselor
  • Ann Arbor, MI
National Provider Identifier
1811183601
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6401010375 Issued in MI
Practice address
343 S Main St Ste 203
Ann Arbor, MI 48104-2116
Phone
(734) 787-8966
Fax
(734) 794-3797
NPI assigned
Sep 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 54002 CA
Marriage & Family Therapist 106H00000X 54002 CA
Professional Counselor 101YP2500X 6401010375 MI Primary

Addresses

Primary practice location

343 S Main St Ste 203
Ann Arbor, MI 48104-2116

Mailing address

343 S Main St Ste 203
Ann Arbor, MI 48104-2116
Phone (734) 787-8966

Other identifiers 1

IdentifierTypeStateIssuer
1841883832MedicaidMI

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
6401010375MIMDProfessional Counselor
54002CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling by Coryanna, PLLC Professional CurrentSince Feb 1, 2021 Accepting new patients

Locations

343 S Main St
Ste 203
Ann Arbor, MI 48104
Phone (734) 787-8966

455 E Eisenhower Pkwy
Ste 300
Ann Arbor, MI 48108
Phone (517) 580-5727

2750 Carpenter Rd
Ste 6
Ann Arbor, MI 48108
Phone (734) 215-5618

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1811183601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 S MAIN ST STE 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042116",
            "telephone_number": "734-787-8966",
            "fax_number": "734-794-3797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 S MAIN ST STE 203",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042116",
            "telephone_number": "734-787-8966",
            "fax_number": "734-794-3797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KU",
        "first_name": "CORYANNA",
        "middle_name": "L",
        "credential": "LPC,  NCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-14",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": "54002",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54002",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401010375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841883832",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.