Provider Demographics
NPI:1336484567
Name:VANDERZANDEN, JOSEPH ALLEN (LPC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALLEN
Last Name:VANDERZANDEN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27620 FARMINGTON RD STE B1
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3367
Mailing Address - Country:US
Mailing Address - Phone:248-274-4978
Mailing Address - Fax:248-671-0556
Practice Address - Street 1:27620 FARMINGTON RD STE B1
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3367
Practice Address - Country:US
Practice Address - Phone:248-274-4978
Practice Address - Fax:248-671-0556
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-28
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401009804101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health