Active NPI
Lauren Ann Van Laethem, MA, CBIS, CRC
- Rehabilitation Counselor
- Cornelius, NC
National Provider Identifier
1003578949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- 324570
- Practice address
- 11406 Heritage Green Dr
Cornelius, NC 28031-7402 - Phone
- (704) 733-0111
- NPI assigned
- Oct 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | 324570 | NC | Primary |
Addresses
Primary practice location
11406 Heritage Green Dr
Cornelius, NC 28031-7402
Mailing address
11406 Heritage Green Dr
Cornelius, NC 28031-7402
Phone (704) 733-0111
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 324570 | NC | MD | Rehabilitation Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1633564800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633564800000",
"number": "1003578949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11406 HERITAGE GREEN DR",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280317402",
"telephone_number": "704-733-0111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11406 HERITAGE GREEN DR",
"city": "CORNELIUS",
"state": "NC",
"postal_code": "280317402",
"telephone_number": "704-733-0111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN LAETHEM",
"first_name": "LAUREN",
"middle_name": "ANN",
"credential": "MA, CBIS, CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-10-07",
"last_updated": "2021-10-07",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NC",
"license": "324570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cornelius, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.