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Organization
VAN'S CONSULTING SERVICES, P.C.
Active
Organization
VAN'S CONSULTING SERVICES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMARA LYNNE VANBAALEN LCSW (PRESIDENT)
(260) 471-7800
Entity
Organization
Contact information
Practice address
1415 MAGNAVOX WAY, SUITE 120, FORT WAYNE, IN 46804-1565
(260) 471-7800
Mailing address
1415 MAGNAVOX WAY, SUITE 120, FORT WAYNE, IN 46804-1565
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003564A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341875
ANTHEM BCBS
IN
01
—
030305
MHN TRICARE
IN
01
—
7733638
AETNA
IN
Enumeration date
05/03/2007
Last updated
08/22/2020
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