Individual
SARA ROSE VAN KONINGSVELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 W BROADWAY STE 155, GLENDALE, CA 91204-1332
(818) 441-7800
Mailing address
PO BOX 642900, LOS ANGELES, CA 90064-8314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
13952768-6004
UT
101YM0800X
Mental Health Counselor
LPC10289
WI
101YP2500X
Professional Counselor
Primary
LPCC8233
CA
225600000X
Dance Therapist
BCDMT1207
—
Other
Enumeration date
10/19/2011
Last updated
04/20/2026
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