Hannah Sue Vandenboom

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

7401001701 Issued in MI

Practice address

910 Spring St
Petoskey, MI 49770-2881

Phone

(616) 322-7358

NPI assigned

Feb 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770768000000",
    "number": "1285199281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 DAM RD",
            "city": "BOYNE CITY",
            "state": "MI",
            "postal_code": "497129613",
            "telephone_number": "616-322-7358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SPRING ST",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497702881",
            "telephone_number": "616-322-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBOOM",
        "first_name": "HANNAH",
        "middle_name": "SUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2026-02-11",
        "certification_date": "2026-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MI",
            "license": "7401001701",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mason Sylar Valor, PHD, LPC, CAADC
• Lindsay Sophia Van Daele, LLMSW
• Theresa Van Fleet
• Craig Theodore Van Woudenberg, DC
• Bradley T Vanassche, MD
• Philip Daniel Vanderkooy, DO
• Brooke M Vandonkelaar, CCC-SLP
• Ken Vanevery, CADC
• Timothy Vanevery, M.D.
• Tanya Vanillo

• Behavior Analyst in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Behavior Analyst in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2026; 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.