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Individual

MR. MIKE DALE LARSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
3110 W PINHOOK RD # 20, LAFAYETTE, LA 70508-3453
(337) 450-9910
Mailing address
3110 W PINHOOK RD # 20, LAFAYETTE, LA 70508-3453
(337) 450-9910

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9186
LA

Other

Enumeration date
08/19/2025
Last updated
08/19/2025
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