Larsen, Gary Young
Larsen, Gary Young is an sole proprietor health care provider with primary practice located at 601 Willow Ave , Council Bluffs IA 51501-4242. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Larsen, Gary Young can be contacted via phone (712) 323-1728.Contact Information
Primary practice address
601 Willow Ave
Council Bluffs IA 51501-4242
Phone: (712) 323-1728
Fax: (712) 323-8888
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 116 | Iowa |
Profile Details
| NPI number | 1548292972 |
|---|---|
| LBN Legal business name | Larsen, Gary Young |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548292972 | NPPES |
| Iowa | MEDICAID | 0100495 |
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