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Individual
MR. KEVIN DUANE LARRY
Active
Individual
MR. KEVIN DUANE LARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CSW003802
GA
104100000X
Social Worker
Primary
6801061643
MI
1041C0700X
Clinical Social Worker
6801061643
MI
1041C0700X
Clinical Social Worker
CSW003802
GA
Other
Enumeration date
09/25/2007
Last updated
05/16/2025
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