Provider Demographics
NPI:1093194243
Name:VANDERLAAN, KAITLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:VANDERLAAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 DURHAM RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-9680
Mailing Address - Country:US
Mailing Address - Phone:215-680-5782
Mailing Address - Fax:
Practice Address - Street 1:842 DURHAM RD STE 200
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9680
Practice Address - Country:US
Practice Address - Phone:215-680-5782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-20
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
PACW019740104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker