Provider Demographics
NPI:1528377017
Name:KARANJA, KATHRYN M (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:M
Last Name:KARANJA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:M
Other - Last Name:RIVEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-S
Mailing Address - Street 1:120 W EXCHANGE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2834
Mailing Address - Country:US
Mailing Address - Phone:989-723-8239
Mailing Address - Fax:989-723-8230
Practice Address - Street 1:120 W EXCHANGE ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2834
Practice Address - Country:US
Practice Address - Phone:989-723-8239
Practice Address - Fax:989-723-8230
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0800026-SUPV1041C0700X
MI68010876901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI.0800026-SUPVOtherLISW-S
MI6801087690OtherLMSW