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General NPI Number Information
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NPI Number | 1346560471
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Entity Type | Individual
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Provider Name | CAROL A LARSON LMHP, CPC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2010
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Last Update Date | 01/29/2016
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Provider Practice Location Address
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Address Line | 124 W 46TH ST STE 204
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City | KEARNEY
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State | NE
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Zip | 68847-8348
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Country | US
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Telephone | 308-236-2014
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Fax | 308-236-6940
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Provider Business Mailing Address
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Address Line | 124 W 46TH ST STE 204
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City | KEARNEY
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State | NE
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Zip | 68847-8348
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Country | US
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Telephone | 308-236-2014
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Fax | 308-236-6940
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1513
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2049
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 4176
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License Number State | NE
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