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Individual
SARAH ELLEN LARSON
Active
Individual
SARAH ELLEN LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R038726-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000523774003
BLUECROSSBLUESHIELD
NY
01
—
6207965
INDEPENDENT HEALTH
NY
Enumeration date
07/03/2006
Last updated
07/08/2007
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