David Alan Vanderwal, MA/LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401005560 Issued in MI

Practice address

6670 Kalamazoo Ave SE
Suite D
Kentwood, MI 49508-7856

Phone

(616) 565-4159

Fax

(616) 565-4161

NPI assigned

Feb 6, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202256000000",
    "number": "1104004712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 SUNNYVIEW DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182129",
            "telephone_number": "616-457-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 KALAMAZOO AVE SE",
            "address_2": "SUITE D",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495087856",
            "telephone_number": "616-565-4159",
            "fax_number": "616-565-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWAL",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "MA/LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2008-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401005560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Vander Linde, MD
• Megan Vanderhoof, OTRL
• Grant Michael Vanderklipp
• Nathan Vanderloo, D.C.
• Jason Vanderploeg, OD
• Jesse Wade Vandommelen
• Juliette Mae Vanhorn
• Brittney Nicole Vankoevering
• Haidyn Johanna Vankoevering
• Cody Vannorman, PHARMD

• Professional Counselor in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.