Provider Demographics
NPI:1285819987
Name:VAN INGEN COUNSELING LLC
Entity Type:Organization
Organization Name:VAN INGEN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN INGEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:724-538-3103
Mailing Address - Street 1:217 E MAIN ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:EVANS CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16033-1261
Mailing Address - Country:US
Mailing Address - Phone:724-538-3103
Mailing Address - Fax:
Practice Address - Street 1:217 E MAIN ST
Practice Address - Street 2:SUITE 1
Practice Address - City:EVANS CITY
Practice Address - State:PA
Practice Address - Zip Code:16033-1261
Practice Address - Country:US
Practice Address - Phone:724-538-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-01
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0156611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty