Dauksavage, Larry Gerard

Dauksavage, Larry Gerard is an individual health care provider with primary practice located at 151 S 4Th St Suite 401, Grand Forks ND 58201-4715. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Dauksavage, Larry Gerard can be contacted via phone (701) 795-3000.

Contact Information

Primary practice address
151 S 4Th St Suite 401 Grand Forks ND 58201-4715
Phone: (701) 795-3000
Fax: (701) 795-3050
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 3176 North Dakota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 3176 North Dakota

Profile Details

NPI number 1982773453
LBN Legal business name Dauksavage, Larry Gerard
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 7th, 2006
Last updated Jul 11th, 2012 - about 12 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 1982773453 NPPES
North Dakota MEDICAID 054519

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