Healthcare Provider Details

I. General information

NPI: 1447635644
Provider Name (Legal Business Name): AMAURITA KANAI PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 3RD AVE SW STE 214
CARMEL IN
46032-7593
US

IV. Provider business mailing address

1033 3RD AVE SW STE 102
CARMEL IN
46032-7592
US

V. Phone/Fax

Practice location:
  • Phone: 317-800-9044
  • Fax:
Mailing address:
  • Phone: 317-800-9044
  • Fax: 317-922-1690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number20043248A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number20043248A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number20043248A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: