Active NPI
David Van Der Vieren, LPCI
- Counselor
- Carrollton, TX
National Provider Identifier
1508390634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 75615
- Practice address
- 4221 Medical Pkwy
Suite 400
Carrollton, TX 75010-4541 - Phone
- (952) 457-7086
- NPI assigned
- Apr 14, 2017
- Last updated
- Apr 14, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 75615 | TX | Primary |
Addresses
Primary practice location
4221 Medical Pkwy
Suite 400
Carrollton, TX 75010-4541
Mailing address
4221 Medical Parkway
Suite 400
Carrollton, TEXAS 75010
UM
Phone (952) 457-7086
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
| License | State | Type | Specialty |
|---|---|---|---|
| 75615 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1508390634",
"addresses": [
{
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "4221 MEDICAL PARKWAY",
"address_2": "SUITE 400",
"city": "CARROLLTON",
"state": "TEXAS",
"postal_code": "75010",
"telephone_number": "952-457-7086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4221 MEDICAL PKWY",
"address_2": "SUITE 400",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750104541",
"telephone_number": "952-457-7086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DER VIEREN",
"first_name": "DAVID",
"credential": "LPCI",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "75615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.