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General NPI Number Information
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NPI Number | 1558560045
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Entity Type | Individual
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Provider Name | ELIZABETH GRACE LARSON M.S., LMHC, LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2007
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Last Update Date | 02/22/2011
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Provider Practice Location Address
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Address Line | 127 FRANKLIN RD STE 215
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City | BRENTWOOD
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State | TN
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Zip | 37027-4662
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Country | US
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Telephone | 615-663-8464
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Fax |
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Provider Business Mailing Address
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Address Line | 127 FRANKLIN RD STE 215
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City | BRENTWOOD
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State | TN
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Zip | 37027-4662
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Country | US
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Telephone | 615-663-8464
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6901
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License Number State | MA
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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 | 2645
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License Number State | TN
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