MEDICARE: MARTHA LAROSA SCRANTON 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	101YM0800X	Mental Health Counselor	LCSW-10195	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821278623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTHA LAROSA SCRANTON LCSW

Provider Business Mailing Address
First Line	:	13239 E KING JOHN RD STE 50722
Second Line	:
City	:	PARKS
State	:	AZ
Zip	:	86018-0350
Country	:	US
Telephone Number	:	928-856-0341
Fax Number	:

Provider Business Practice Location Address
First Line	:	13239 E KING JOHN RD STE 50722
Second Line	:	STE 50722
City	:	PARKS
State	:	AZ
Zip	:	86018-0350
Country	:	US
Telephone Number	:	928-856-0341
Fax Number	:

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

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	03/03/2026

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