| Larsen Counseling Pllc | |
|
7665 Custer Rd Fruitland ID 83619-5039 | |
| (208) 550-0222 | |
| Not Available |
| Full Name | Larsen Counseling Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 7665 Custer Rd, Fruitland, Idaho |
| Authorized Official Name and Position | Frankie D. Larsen (OWNER) |
| Authorized Official Contact | 2085500222 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Larsen Counseling Pllc 7665 Custer Rd Fruitland ID 83619-5039 Ph: (208) 550-0222 | Larsen Counseling Pllc 7665 Custer Rd Fruitland ID 83619-5039 Ph: (208) 550-0222 |
| NPI Number | 1003437658 |
|---|---|
| Provider Enumeration Date | 05/05/2020 |
| Last Update Date | 05/05/2020 |
| Certification Date | 05/05/2020 |
| Medicare PECOS PAC ID | 6709217078 |
|---|---|
| Medicare Enrollment ID | O20200521000535 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003437658 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Frankie Diane Larsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669609020 PECOS PAC ID: 7517398886 Enrollment ID: I20200601000932 |
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