| Kaneti Psychology Services, Llc | |
|
4070 Lake Dr Se Ste 101 Grand Rapids MI 49546-8294 | |
| (616) 449-2400 | |
| Not Available |
| Full Name | Kaneti Psychology Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4070 Lake Dr Se Ste 101, Grand Rapids, Michigan |
| Authorized Official Name and Position | Catharine Kaneti (OWNER) |
| Authorized Official Contact | 6162461472 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaneti Psychology Services, Llc 4070 Lake Dr Se Ste 101 Grand Rapids MI 49546-8294 Ph: (616) 246-1472 | Kaneti Psychology Services, Llc 4070 Lake Dr Se Ste 101 Grand Rapids MI 49546-8294 Ph: (616) 449-2400 |
| NPI Number | 1073112843 |
|---|---|
| Provider Enumeration Date | 10/22/2020 |
| Last Update Date | 07/27/2022 |
| Certification Date | 07/27/2022 |
| Medicare PECOS PAC ID | 4688084734 |
|---|---|
| Medicare Enrollment ID | O20201102000952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073112843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Catharine M Kaneti |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841227659 PECOS PAC ID: 4183778814 Enrollment ID: I20090814000543 |
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