Provider Demographics
NPI:1356512693
Name:VANBOCKEL, FRAN J (LPC, RN)
Entity type:Individual
Prefix:
First Name:FRAN
Middle Name:J
Last Name:VANBOCKEL
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N EXENE ST # 17
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:SD
Mailing Address - Zip Code:57442-1104
Mailing Address - Country:US
Mailing Address - Phone:605-765-2164
Mailing Address - Fax:
Practice Address - Street 1:105 N EXENE ST # 17
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:SD
Practice Address - Zip Code:57442-1104
Practice Address - Country:US
Practice Address - Phone:605-765-2164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1154101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDR024957OtherSD-RN R024957
SD1154OtherLPC