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General NPI Number Information
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NPI Number | 1972439925
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Entity Type | Organization
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Legal Business Name | MELISSA LARSEN LCSW PLLC
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Dates
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Enumeration Date | 06/18/2026
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Last Update Date | 06/18/2026
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Provider Practice Location Address
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Address Line | 718 SHOSHONE ST E
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City | TWIN FALLS
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State | ID
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Zip | 83301-6111
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Country | US
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Telephone | 208-829-9441
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 E 3290 N
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City | KIMBERLY
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State | ID
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Zip | 83341-5332
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Country | US
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Telephone | 208-829-9441
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | MELISSA LARSEN
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Credential | LCSW
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Telephone | 208-829-9441
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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 |
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License Number State |
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