Provider Demographics
NPI:1427230283
Name:VANKLAVEREN, LAUREL A (LHMC, LCPC)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:A
Last Name:VANKLAVEREN
Suffix:
Gender:F
Credentials:LHMC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 KIMBERLY RD STE 96S
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3505
Mailing Address - Country:US
Mailing Address - Phone:563-396-2625
Mailing Address - Fax:563-888-8485
Practice Address - Street 1:2435 KIMBERLY RD STE 96S
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3505
Practice Address - Country:US
Practice Address - Phone:563-396-2625
Practice Address - Fax:563-888-8485
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180-005323101YM0800X
IA01007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health