Provider Demographics
NPI:1073520490
Name:VAN LANEN, DELORES JOAN (ATR, MAAT, LCPC)
Entity Type:Individual
Prefix:
First Name:DELORES
Middle Name:JOAN
Last Name:VAN LANEN
Suffix:
Gender:F
Credentials:ATR, MAAT, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3404 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-3932
Mailing Address - Country:US
Mailing Address - Phone:847-729-9073
Mailing Address - Fax:
Practice Address - Street 1:3404 MEADOW LN
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-3932
Practice Address - Country:US
Practice Address - Phone:847-729-9073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional