MEDICARE: DR. CHERUBA A DHANARAJ PHD, LPC, MBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	6401224272	MI

General Provider Information

NPI Number	:	1003502964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERUBA A DHANARAJ PHD, LPC, MBA

Provider Business Mailing Address
First Line	:	2280 S 11TH ST STE 225
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-1910
Country	:	US
Telephone Number	:	616-635-0677
Fax Number	:

Provider Business Practice Location Address
First Line	:	2280 S 11TH ST STE 225
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49009-1910
Country	:	US
Telephone Number	:	209-645-2577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2023
Last Update Date	:	06/25/2025

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