Individual provider Active NPI

Kevin Vankorlaar, LMHC

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1154607968
Registry record updated Feb 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH4228 Issued in FL
Practice address
1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789-4679
Phone
(407) 896-8097
Fax
(407) 898-8328
NPI assigned
Oct 25, 2011
Last updated
Feb 22, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH4228 FL Primary

Addresses

Primary practice location

1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789-4679

Mailing address

1573 W Fairbanks Ave Ste 100
Winter Park, FL 32789-4679
Phone (407) 896-8097

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240220000604 FL Practitioner - Mental Health Counselor 3274816889 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH4228FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

1685 Lee Rd
Ste 100
Winter Park, FL 32789
Phone (407) 896-8097

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708560000000",
    "number": "1154607968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-896-8097",
            "fax_number": "407-898-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1573 W FAIRBANKS AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894679",
            "telephone_number": "407-896-8097",
            "fax_number": "407-898-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANKORLAAR",
        "first_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-25",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.