Individual provider Active NPI

Laurel A. Vanklaveren, LHMC, LCPC

  • Mental Health Counselor
  • Bettendorf, IA
National Provider Identifier
1427230283
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01007 Issued in IA
Practice address
2435 Kimberly Rd Ste 96S
Bettendorf, IA 52722-3505
Phone
(563) 396-2625
Fax
(563) 888-8485
NPI assigned
Dec 3, 2007
Last updated
Jun 18, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180-005323 IL
Mental Health Counselor 101YM0800X 01007 IA Primary

Addresses

Primary practice location

2435 Kimberly Rd Ste 96S
Bettendorf, IA 52722-3505

Mailing address

2435 Kimberly Rd Ste 96S
Bettendorf, IA 52722-3505
Phone (563) 396-2625

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

State licenses

LicenseStateTypeSpecialty
01007IAMDAddiction (Substance Use Disorder) Counselor
180-005323ILMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Rae Counseling Services, LLC Mental Health Current Accepting new patients

Locations

2435 Kimberly Rd
Ste 96S
Bettendorf, IA 52722
Phone (563) 202-7373

Organizations & group practices 1

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1427230283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 KIMBERLY RD STE 96S",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223505",
            "telephone_number": "563-396-2625",
            "fax_number": "563-888-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 KIMBERLY RD STE 96S",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223505",
            "telephone_number": "563-396-2625",
            "fax_number": "563-888-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANKLAVEREN",
        "first_name": "LAUREL",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "LHMC, LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180-005323",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "01007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.

Verify at the official NPI Registry.