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General NPI Number Information
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NPI Number | 1982465654
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Entity Type | Organization
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Legal Business Name | ANGELA M LARCOM LLC
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Dates
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Enumeration Date | 01/19/2024
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 1511 E MINNESOTA ST
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City | SAINT JOSEPH
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State | MN
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Zip | 56374-8618
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Country | US
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Telephone | 320-260-3471
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 653
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City | SAINT JOSEPH
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State | MN
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Zip | 56374-0653
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Country | US
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Telephone | 320-260-3471
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Fax |
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Authorized Official
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Title or Position | LPCC
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Name | ANGELA LARCOM
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Credential | MA
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Telephone | 320-260-3471
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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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