Healthcare Provider Details

I. General information

NPI: 1447366828
Provider Name (Legal Business Name): CATHERINE J LARSEN MS, LPC-MH, QMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 JACKSON BLVD STE 7
RAPID CITY SD
57702-3474
US

IV. Provider business mailing address

2650 JACKSON BLVD STE 7
RAPID CITY SD
57702-3474
US

V. Phone/Fax

Practice location:
  • Phone: 605-484-6096
  • Fax: 605-252-7226
Mailing address:
  • Phone: 605-484-6096
  • Fax: 605-252-7226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-MH2110
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6575880
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: