Active NPI
Katherine Ann Vanderaa Jansen, M.A.
- Mental Health Counselor
- Raleigh, NC
National Provider Identifier
1467758607
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 8179
- Practice address
- 3733 National Dr
Suite 114
Raleigh, NC 27612-4065 - Phone
- (919) 448-7564
- NPI assigned
- Feb 7, 2011
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 8179 | NC | Primary |
Addresses
Primary practice location
3733 National Dr
Suite 114
Raleigh, NC 27612-4065
Mailing address
3733 National Dr
Suite 114
Raleigh, NC 27612-4065
Phone (919) 448-7564
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 |
|---|---|---|---|
| 8179 | NC | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297036800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297036800000",
"number": "1467758607",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3733 NATIONAL DR",
"address_2": "SUITE 114",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124065",
"telephone_number": "919-448-7564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3733 NATIONAL DR",
"address_2": "SUITE 114",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276124065",
"telephone_number": "919-448-7564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JANSEN",
"first_name": "KATHERINE",
"middle_name": "ANN VANDERAA",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-02-07",
"last_updated": "2011-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "8179",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.