Larson, Phyllis
Larson, Phyllis is an individual health care provider with primary practice located at 1432 Southwest Blvd , Jefferson City MO 65109. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Larson, Phyllis can be contacted via phone (573) 632-5560.Contact Information
Primary practice address
1432 Southwest Blvd
Jefferson City MO 65109
Phone: (573) 632-5560
Fax: (573) 632-5875
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 434 | Missouri |
Profile Details
| NPI number | 1891732707 |
|---|---|
| LBN Legal business name | Larson, Phyllis |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 31st, 2006 |
| Last updated | Jul 1st, 2009 - about 15 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 | 1891732707 | NPPES |
| Missouri | Other | 166304 | BCBS |
| Missouri | MEDICAID | 493531677 | BCBS |
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