Provider Demographics
NPI:1205305943
Name:VANHAMM
Entity type:Organization
Organization Name:VANHAMM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANUTE
Authorized Official - Middle Name:
Authorized Official - Last Name:VANBEYSTERVELDT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-354-6688
Mailing Address - Street 1:5655 N HIGH ST STE 208
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3948
Mailing Address - Country:US
Mailing Address - Phone:614-505-6977
Mailing Address - Fax:614-505-3548
Practice Address - Street 1:5655 N HIGH ST STE 208
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-3948
Practice Address - Country:US
Practice Address - Phone:614-505-6977
Practice Address - Fax:614-505-3548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-23
Last Update Date:2018-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty