Janice Marie Kornacki, MA LLP
Psychologist, Clinical in Wayne, MI. Individual provider (NPI-1).
NPI number1720167166
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1720167166
- Entity type
- Individual (NPI-1)
- Name
- Ms. Janice Marie Kornacki
- Credential
- MA LLP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 6301010055 | MI | Yes |
Practice location
33101 Annapolis StWayne, MI 48184-2405
Phone 734-721-0200
Mailing address
24601 Chicago StDearborn, MI 48124-3106
Phone 313-792-9284
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 8 Clinical Psychologist providers in Wayne · All 873 providers in Wayne
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