| Doctor Name: | DR. KEVIN VANKORLAAR |
| NPI Number: | 1154607968 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC |
| License Number: | MH4228 |
| Business Practice Address: | 1420 Celebration Blvd Suite 200 Celebration, FL - 347475159 |
| Business Phone Number: | 4075662282 |
| Business Fax Number: | 8634223275 |
| Mailing Address: | 40124 Highway 27, Suite 104 DAVENPORT |
| State: | FL |
| Postal Code: | 338375905 |
| Phone Number: | 8634217069 |
| Fax Number: | 8634223275 |
| NPI Enumeration Date: | 10/25/2011 |
| NPI Last Update Date: | 10/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MH4228 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |