Healthcare Provider Details

I. General information

NPI: 1790624591
Provider Name (Legal Business Name): SAMANTHA LARSON LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 16TH ST W STE 31
BILLINGS MT
59102-4100
US

IV. Provider business mailing address

1216 16TH ST W STE 31
BILLINGS MT
59102-4100
US

V. Phone/Fax

Practice location:
  • Phone: 406-274-7623
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA LARSON
Title or Position: OWNER
Credential: LCSW
Phone: 406-274-7623