Provider Demographics
NPI:1750268678
Name:VAN GENT, KAYLEE (MA, LAPC, NCC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:VAN GENT
Suffix:
Gender:F
Credentials:MA, LAPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KENLEY CT
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1171
Mailing Address - Country:US
Mailing Address - Phone:724-372-5673
Mailing Address - Fax:
Practice Address - Street 1:100 KENLEY CT
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-1171
Practice Address - Country:US
Practice Address - Phone:724-372-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health