Organization
MARK T. LARSEN, LPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK TIMOTHY LARSEN LPC (OWNER/MEMBER)
(276) 698-5595
Entity
Organization
Contact information
Practice address
170 NOTTINGHAM DR, WYTHEVILLE, VA 24382-1412
(276) 698-5595
Mailing address
170 NOTTINGHAM DR, WYTHEVILLE, VA 24382-1412
(276) 698-5595
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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