Kira Sue Van Der Laar, LISW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

I.1901397 Issued in OH

Practice address

430 N Broadway St
Green Springs, OH 44836-9734

Phone

(844) 534-3638

NPI assigned

Nov 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• 360Team Counseling LLC

  • Psychologist
  • Perrysburg, OH
  • NPI 1881277242

  Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1689276263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W MADISON ST",
            "city": "GIBSONBURG",
            "state": "OH",
            "postal_code": "434311221",
            "telephone_number": "567-201-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N BROADWAY ST",
            "city": "GREEN SPRINGS",
            "state": "OH",
            "postal_code": "448369734",
            "telephone_number": "844-534-3638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 W Madison St",
            "address_purpose": "LOCATION",
            "city": "Gibsonburg",
            "state": "OH",
            "postal_code": "434311221",
            "country_code": "US",
            "telephone_number": "567-201-6450",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DER LAAR",
        "first_name": "KIRA",
        "middle_name": "SUE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.1901397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dru Troyer
• Josh Levi Tyree, CDCA, PRS
• Tiffani Amber Vollmar
• Adam Timothy Ward, LPN
• Zoe Mae Warren
• Misty Nichole Weaver
• Alexis Weichman, CDCA

• Mental Health Counselor in Green Springs, OH
• Providers in Green Springs, OH by specialty
• Mental Health Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.