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General NPI Number Information
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NPI Number | 1295413185
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Entity Type | Individual
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Provider Name | KHARISHA MAE LAROCO
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Gender | Female
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 128 EAST AVE
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City | NORWALK
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State | CT
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Zip | 06851-5738
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Country | US
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Telephone | 475-666-0745
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Fax |
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Provider Business Mailing Address
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Address Line | 637 COVE RD UNIT A5
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City | STAMFORD
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State | CT
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Zip | 06902-5401
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | CT
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