MEDICARE: MR. DUSTIN ART LARNA

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
1	101YM0800X	Mental Health Counselor		AK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396349007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DUSTIN ART LARNA

Provider Business Mailing Address
First Line	:	PO BOX 7475
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-2475
Country	:	US
Telephone Number	:	907-220-7299
Fax Number	:	907-885-6613

Provider Business Practice Location Address
First Line	:	2524 FIRST AVE
Second Line	:
City	:	KETCHIKAN
State	:	AK
Zip	:	99901-5804
Country	:	US
Telephone Number	:	907-220-7299
Fax Number	:	907-885-6613

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2020
Last Update Date	:	05/26/2025

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Directions to “ MR. DUSTIN ART LARNA ” Practice Location

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