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NPI Code Detail

MEDICARE: MATTHEW ALOF LARSON CMHC

MEDICARE:   MATTHEW ALOF LARSON  CMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor13009913-6004UT

General Provider Information

NPI Number : 1386065605
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW ALOF LARSON CMHC
Provider Business Mailing Address
First Line : 564 S 100 E
Second Line :
City : MANTI
State : UT
Zip : 84642-1703
Country : US
Telephone Number : 435-851-0458
Fax Number :
Provider Business Practice Location Address
First Line : 37 W 700 S
Second Line :
City : EPHRAIM
State : UT
Zip : 84627-1524
Country : US
Telephone Number : 435-851-0458
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2014
Last Update Date : 03/05/2026

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