Provider Demographics
NPI:1851198949
Name:VANWANZEELE, KAMRYN
Entity type:Individual
Prefix:
First Name:KAMRYN
Middle Name:
Last Name:VANWANZEELE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9240 N MERIDIAN ST STE 340
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2850
Mailing Address - Country:US
Mailing Address - Phone:317-291-1967
Mailing Address - Fax:
Practice Address - Street 1:9240 N MERIDIAN ST STE 340
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2850
Practice Address - Country:US
Practice Address - Phone:317-291-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health