Archuleta, Larissa Ferne

Archuleta, Larissa Ferne is an sole proprietor health care provider with primary practice located at 962 Chambers St Ste 11 , South Ogden UT 84403-5092. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Archuleta, Larissa Ferne can be contacted via phone (801) 625-3700.

Contact Information

Primary practice address
962 Chambers St Ste 11 South Ogden UT 84403-5092
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7756352-3501 Utah

Profile Details

NPI number 1669806246
LBN Legal business name Archuleta, Larissa Ferne
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2013
Last updated Jan 17th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669806246 NPPES
Utah Other 260022408 RAILROAD MEDICARE
Utah MEDICAID 876000308007 RAILROAD MEDICARE

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