Emily Van Der Laan, MA LPC INTERN

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R6313 Issued in OR

Practice address

3519 NE 15TH Ave # 360
Portland, OR 97212-2356

Phone

(541) 357-6878

NPI assigned

Feb 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1982295937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14345 NE KNOTT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972303832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3519 NE 15TH AVE # 360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972122356",
            "telephone_number": "541-357-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER LAAN",
        "first_name": "EMILY",
        "credential": "MA LPC INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "R6313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gaianbody@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "Encrypted email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3519 NE 15th Ave # 360",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972122356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Andrea Lynn Van de Bruggen, MA
• Katherine M Van de Coevering, RN/QMHP
• Alan Van de Water
• Sara Van Den Heuvel, MSW
• Faye Van Der Fluit, PHD
• Andrew Russell Van Der Werf, LMT
• Ryan Van Dordrecht
• Katherin Thomson Van Doren, MA COUNSELING ART TX
• Karen Van Dusen, BA
• Leah Rae Van Dusen, CADC-R

• Mental Health Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.