MEDICARE: VAN KALSBEEK COUNSELING LLC

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

General Provider Information

NPI Number	:	1437972791
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN KALSBEEK COUNSELING LLC

Provider Business Mailing Address
First Line	:	225 N CLIFF AVE STE 4
Second Line	:
City	:	HARRISBURG
State	:	SD
Zip	:	57032-2524
Country	:	US
Telephone Number	:	605-610-9094
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 N CLIFF AVE STE 4
Second Line	:
City	:	HARRISBURG
State	:	SD
Zip	:	57032-2524
Country	:	US
Telephone Number	:	605-610-9094
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMANDA VAN KALSBEEK
Credential	:	MS, LPC-MH, NCC
Telephone Number	:	605-610-9094

Provider Enumeration Date	:	11/05/2024
Last Update Date	:	11/05/2024

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