MEDICARE: MRS. LANA LYNN VAN EGEREN LCSW

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	1041C0700X	Clinical Social Worker	237	CO

General Provider Information

NPI Number	:	1407868243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LANA LYNN VAN EGEREN LCSW

Provider Business Mailing Address
First Line	:	9362 TEDDY LN STE 206
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-2871
Country	:	US
Telephone Number	:	303-916-2547
Fax Number	:	303-705-8039

Provider Business Practice Location Address
First Line	:	9362 TEDDY LN STE 206
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-2871
Country	:	US
Telephone Number	:	303-916-2547
Fax Number	:	303-705-8039

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	01/31/2025

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