MEDICARE: MRS. MARY ANN VANDER VEER MA, 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
1	101YM0800X	Mental Health Counselor	LH60454153	WA
2	101YM0800X	Mental Health Counselor	CG60113142	WA
3	101YM0800X	Mental Health Counselor	CP2907R	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1801149745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY ANN VANDER VEER MA, LMHC

Provider Business Mailing Address
First Line	:	7331 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1570
Country	:	US
Telephone Number	:	702-980-5241
Fax Number	:	702-975-8232

Provider Business Practice Location Address
First Line	:	7331 W CHARLESTON BLVD STE 140
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-1570
Country	:	US
Telephone Number	:	360-957-5898
Fax Number	:	702-489-7844

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

Provider Enumeration Date	:	10/16/2012
Last Update Date	:	02/15/2022

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