Provider Demographics
NPI:1487731568
Name:VANLANINGHAM, KIRK (LPC)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:VANLANINGHAM
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 EXECUTIVE CENTER DR
Mailing Address - Street 2:STE. 158
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1643
Mailing Address - Country:US
Mailing Address - Phone:512-637-9089
Mailing Address - Fax:512-340-0096
Practice Address - Street 1:3636 EXECUTIVE CENTER DR
Practice Address - Street 2:STE. 158
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1643
Practice Address - Country:US
Practice Address - Phone:512-637-9089
Practice Address - Fax:512-340-0096
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13158101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional