MEDICARE: LAURA VAN SAUN

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1649812652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA VAN SAUN

Provider Business Mailing Address
First Line	:	632 N 2ND ST FRNT 1051
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	632 N 2ND ST FRNT 1051
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-3046
Country	:	US
Telephone Number	:	267-225-3283
Fax Number	:

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

Provider Enumeration Date	:	10/10/2019
Last Update Date	:	01/20/2026

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Directions to “ LAURA VAN SAUN ” Practice Location

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