Active NPI
Jerren Weekes-Kanu, PH.D.
- Health Service Psychologist
- Canton, MI
National Provider Identifier
1851756738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Service Psychologist
- License
- 6301015751
- Practice address
- 41086 Williamsburg Blvd
Canton, MI 48187-3878 - Phone
- (248) 990-5780
- NPI assigned
- Dec 21, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Health Service Psychologist | 103TH0100X | 6301015751 | MI | Primary |
Addresses
Primary practice location
41086 Williamsburg Blvd
Canton, MI 48187-3878
Mailing address
41086 Williamsburg Blvd
Canton, MI 48187-3878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 15, 2023 through Dec 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015751 | MI | MD | Health Service Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1450656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450656000000",
"number": "1851756738",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41086 WILLIAMSBURG BLVD",
"city": "CANTON",
"state": "MI",
"postal_code": "481873878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41086 WILLIAMSBURG BLVD",
"city": "CANTON",
"state": "MI",
"postal_code": "481873878",
"telephone_number": "248-990-5780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WEEKES-KANU",
"first_name": "JERREN",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-21",
"last_updated": "2015-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": "MI",
"license": "6301015751",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.