MEDICARE: ARIELLE FRANK LARSON LCSW

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	1041C0700X	Clinical Social Worker	55272	TX

General Provider Information

NPI Number	:	1154602209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIELLE FRANK LARSON LCSW

Provider Business Mailing Address
First Line	:	2906 SAN GABRIEL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-3533
Country	:	US
Telephone Number	:	512-662-1588
Fax Number	:	512-271-6365

Provider Business Practice Location Address
First Line	:	2906 SAN GABRIEL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-3533
Country	:	US
Telephone Number	:	512-662-1588
Fax Number	:	512-271-6365

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

Provider Enumeration Date	:	09/02/2011
Last Update Date	:	07/11/2019

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