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NPI Code Detail

MEDICARE: MS. HEATHER C. LARSEN MS, CAGS, LMHC

MEDICARE: MS. HEATHER C. LARSEN MS, CAGS, LMHC
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
1101YM0800XMental Health Counselor5286MA

General Provider Information

NPI Number : 1619023421
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. HEATHER C. LARSEN MS, CAGS, LMHC
Provider Business Mailing Address
First Line : 80 BRUSH HILL AVE
Second Line : APT. 69
City : WEST SPRINGFIELD
State : MA
Zip : 01089-1232
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 96 SOUTH ST
Second Line :
City : WARE
State : MA
Zip : 01082-1616
Country : US
Telephone Number : 413-967-6241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 05/17/2011

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Directions to “ MS. HEATHER C. LARSEN MS, CAGS, LMHC” Practice Location

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