MEDICARE: KAYLA MARIE LARKIN LPCC

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1275021800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA MARIE LARKIN LPCC

Provider Business Mailing Address
First Line	:	6256 COUNTY ROAD 136
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56301-8912
Country	:	US
Telephone Number	:	507-458-2776
Fax Number	:

Provider Business Practice Location Address
First Line	:	1637 4TH AVE N STE 106
Second Line	:
City	:	SAUK RAPIDS
State	:	MN
Zip	:	56379-2783
Country	:	US
Telephone Number	:	507-458-2776
Fax Number	:

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

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	03/03/2026

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