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General NPI Number Information
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NPI Number | 1326412586
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Entity Type | Individual
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Provider Name | CORINNE LESLIE LARSON LPCC
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Gender | Female
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Dates
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Enumeration Date | 11/25/2015
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Last Update Date | 02/12/2026
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Provider Practice Location Address
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Address Line | 7901 XERXES AVE S STE 225
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City | BLOOMINGTON
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State | MN
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Zip | 55431-1253
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Country | US
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Telephone | 952-544-6806
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Fax | 952-545-0098
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Provider Business Mailing Address
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Address Line | 10201 WAYZATA BLVD STE 100
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City | MINNETONKA
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State | MN
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Zip | 55305-1500
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Country | US
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Telephone | 952-544-6806
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Fax | 952-545-0098
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2212
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License Number State | MN
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