Active NPI
Diane M Kanous
- Psychologist
- Kalamazoo, MI
National Provider Identifier
1871638445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301011265
- Practice address
- 3030 S 9TH St
Suite 2GB
Kalamazoo, MI 49009-7956 - Phone
- (269) 544-7720
- Fax
- (269) 544-7721
- NPI assigned
- Feb 21, 2007
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301011265 | MI | Primary |
Addresses
Primary practice location
3030 S 9TH St
Suite 2GB
Kalamazoo, MI 49009-7956
Mailing address
3030 S 9TH St
Suite 2GB
Kalamazoo, MI 49009-7956
Phone (269) 544-7720
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301011265 | MI | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diane M Kanous | Current | Accepting new patients | |
| Dorman and Associates PLC | Psychologist | Past | Accepting new patients |
Locations
3030 S 9th St
Ste 2GB
Kalamazoo, MI 49009
Phone (269) 544-7720
6963 W Kl Ave
#B
Kalamazoo, MI 49009
Phone (269) 544-7720
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.
-
- Counseling Psychologist
- Kalamazoo, MI
- NPI 1588837736
-
- Psychologist
- Kalamazoo, MI
- NPI 1275737413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225929600000",
"number": "1871638445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 S 9TH ST",
"address_2": "SUITE 2GB",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490097956",
"telephone_number": "269-544-7720",
"fax_number": "269-544-7721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 S 9TH ST",
"address_2": "SUITE 2GB",
"city": "KALAMAZOO",
"state": "MI",
"postal_code": "490097956",
"telephone_number": "269-544-7720",
"fax_number": "269-544-7721"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANOUS",
"first_name": "DIANE",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-21",
"last_updated": "2008-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301011265",
"primary": true
}
],
"identifiers": [],
"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 Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.