Individual provider · Type 1 NPI

Sara Rose Van Koningsveld

Professional Counselor · Glendale, CA

NPI number 1104101310 Active

Practice location

225 W Broadway Ste 155
Glendale, CA 91204-1332

Call (818) 441-7800 Map

Mailing address

PO Box 642900
Los Angeles, CA 90064-8314

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800X13952768-6004 (UT)
Professional Counselor Primary 101YP2500XLPCC8233 (CA)
Dance Therapist 225600000XBCDMT1207
Mental Health Counselor 101YM0800XLPC10289 (WI)

Professional Counselor: Definition to come...

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About NPI 1104101310

Sara Rose Van Koningsveld's National Provider Identifier is 1104101310, issued on Oct 19, 2011. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Glendale, CA. The record was last updated on Apr 20, 2026.