MEDICARE: LARRY JAMES LAUVETZ MA LPC

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	2002004525	MO

General Provider Information

NPI Number	:	1831603885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY JAMES LAUVETZ MA LPC

Provider Business Mailing Address
First Line	:	10300 N GARFIELD AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-3244
Country	:	US
Telephone Number	:	816-728-7938
Fax Number	:	816-471-1579

Provider Business Practice Location Address
First Line	:	1509 NE PARVIN RD
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64116-2304
Country	:	US
Telephone Number	:	816-471-2276
Fax Number	:	816-471-1579

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

Provider Enumeration Date	:	11/29/2017
Last Update Date	:	11/29/2017

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