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General NPI Number Information
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NPI Number | 1821435702
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Entity Type | Individual
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Provider Name | SARAH HILLARY LARSEN M.A.C.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2013
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 428 MONTEMAR AVE APT D
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City | CATONSVILLE
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State | MD
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Zip | 21228-5297
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Country | US
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Telephone | 308-850-3509
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Fax | 308-381-5698
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Provider Business Mailing Address
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Address Line | 1811 W 2ND ST STE 475
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City | GRAND ISLAND
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State | NE
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Zip | 68803-5413
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Country | US
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Telephone | 308-850-3509
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Fax | 308-381-5698
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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 | 9960
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License Number State | NE
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