ROBERT VANDERWAL MS LMHC NPI 1265867204

NPI Information

  • NPI: 1265867204
  • Provider Name: ROBERT VANDERWAL, MS, LMHC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 15D0861334
  • Address: 1818 WENT AVE
    MISHAWAKA, IN
    ZIP 46545
  • Phone: (574) 254-0229

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NPI Details

Robert Vanderwal, MS, LMHC is a mental health counselor in Mishawaka, IN. Robert Vanderwal, MS, LMHC NPI is 1265867204. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1818 WENT AVE
MISHAWAKA, IN
ZIP 46545
Phone: (574) 254-0229
Fax: (574) 254-0188

The NPI 1265867204 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The CLIA number assigned to this NPI record is 15D0861334 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/10/2013 and was last updated on 7/31/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health39002492AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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