Healthcare Provider Details

I. General information

NPI: 1265716609
Provider Name (Legal Business Name): AMY LAROWE MA, LPCC, CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 11/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 S HENRY ST
DELAWARE OH
43015-2978
US

IV. Provider business mailing address

250 S HENRY ST
DELAWARE OH
43015-2978
US

V. Phone/Fax

Practice location:
  • Phone: 740-369-4482
  • Fax: 740-368-7835
Mailing address:
  • Phone: 740-369-4482
  • Fax: 740-368-7835

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1000228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: