Larson, Lori M
Larson, Lori M is an individual health care provider with primary practice located at 650 Huebner Rd , Fort Riley KS 66442-4030. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Larson, Lori M can be contacted via phone (785) 240-6560.Contact Information
Primary practice address
650 Huebner Rd
Fort Riley KS 66442-4030
Phone: (785) 240-6560
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | P401 | Nebraska |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 1954 | Nebraska |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 1080 | Nebraska |
Profile Details
| NPI number | 1700952397 |
|---|---|
| LBN Legal business name | Larson, Lori M |
| Credentials | LIMHP, LPC, MAC, ACS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 27th, 2006 |
| Last updated | Feb 1st, 2023 - about 3 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 | 1700952397 | NPPES |
| Nebraska | MEDICAID | 47037661202 | |
| Nebraska | MEDICAID | 10025315600 | |
| Nebraska | MEDICAID | 10025224900 |
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