Individual
MR. KURT DOMINICK LAROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LICSW
Contact information
Practice address
12 N KINGS HWY STE 101, PERRYVILLE, MO 63775-1367
(573) 547-3116
(573) 547-2963
Mailing address
12 N KINGSHIGHWAY ST STE 101, PERRYVILLE, MO 63775-1367
(850) 545-2886
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2020023042
MO
1041C0700X
Clinical Social Worker
LC50081569
DC
1041C0700X
Clinical Social Worker
SW9297
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12243893
CAQH
FL
Enumeration date
05/07/2007
Last updated
02/24/2022
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