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NPI Code Detail

MEDICARE: STEVEN C VANGELDER LMHC

MEDICARE: STEVEN C VANGELDER LMHC
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
1103TA0400XAddiction (Substance Use Disorder) PsychologistCAP 3318FL
2101YM0800XMental Health CounselorMH9157FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023102779
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN C VANGELDER LMHC
Provider Business Mailing Address
First Line : 510 VONDERBURG DRIVE
Second Line : SUITE 301
City : BRANDON
State : FL
Zip : 33511-6072
Country : US
Telephone Number : 813-881-1000
Fax Number : 813-689-2856
Provider Business Practice Location Address
First Line : 565 MEMORIAL CIR
Second Line :
City : ORMOND BEACH
State : FL
Zip : 32174-5001
Country : US
Telephone Number : 386-310-8766
Fax Number : 386-310-8770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 11/25/2019

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