| Mark T. Larsen, Lpc Llc | |
|
170 Nottingham Dr Wytheville VA 24382-1412 | |
| (276) 698-5595 | |
| Not Available |
| Full Name | Mark T. Larsen, Lpc Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 170 Nottingham Dr, Wytheville, Virginia |
| Authorized Official Name and Position | Mark Timothy Larsen (OWNER/MEMBER) |
| Authorized Official Contact | 2766985595 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark T. Larsen, Lpc Llc 170 Nottingham Dr Wytheville VA 24382-1412 Ph: (276) 698-5595 | Mark T. Larsen, Lpc Llc 170 Nottingham Dr Wytheville VA 24382-1412 Ph: (276) 698-5595 |
| NPI Number | 1437812211 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 10/18/2021 |
| Certification Date | 10/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437812211 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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