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General NPI Number Information
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NPI Number | 1205305943
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Entity Type | Organization
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Legal Business Name | VANHAMM
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Dates
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Enumeration Date | 11/23/2018
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Last Update Date | 11/23/2018
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Provider Practice Location Address
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Address Line | 5655 N HIGH ST STE 208
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City | WORTHINGTON
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State | OH
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Zip | 43085-3948
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Country | US
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Telephone | 614-505-6977
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Fax | 614-505-3548
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Provider Business Mailing Address
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Address Line | 5655 N HIGH ST STE 208
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City | WORTHINGTON
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State | OH
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Zip | 43085-3948
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Country | US
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Telephone | 614-505-6977
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Fax | 614-505-3548
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Authorized Official
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Title or Position | OWNER
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Name | DANUTE VANBEYSTERVELDT
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Credential | LPCC
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Telephone | 614-354-6688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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