MEDICARE: ROBIN LARSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E1100001	OH

General Provider Information

NPI Number	:	1063702298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN LARSON

Provider Business Mailing Address
First Line	:	2225 N SAINT JAMES PKWY
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3330
Country	:	US
Telephone Number	:	330-760-4112
Fax Number	:

Provider Business Practice Location Address
First Line	:	2225 N SAINT JAMES PKWY
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3330
Country	:	US
Telephone Number	:	330-760-4112
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	06/27/2024

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Directions to “ ROBIN LARSON ” Practice Location

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