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NPI Code Detail

MEDICARE: ERIC VAN HASELEN

MEDICARE: ERIC VAN HASELEN
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1982313102
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC VAN HASELEN
Provider Business Mailing Address
First Line : 3637 MEADOW LAKE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77027-4110
Country : US
Telephone Number : 214-449-6062
Fax Number :
Provider Business Practice Location Address
First Line : 3637 MEADOW LAKE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77027-4110
Country : US
Telephone Number : 214-449-6062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2022
Last Update Date : 11/16/2022

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Directions to “ ERIC VAN HASELEN ” Practice Location

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