Individual
MS. JENNIFER LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., LCPC, NCC
Contact information
Practice address
25 E WASHINGTON ST STE 1406, CHICAGO, IL 60602-1820
(773) 398-0359
(773) 989-7207
Mailing address
5142 N LEAVITT ST, STE 2, CHICAGO, IL 60625-6829
(773) 398-0359
(773) 989-7207
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180006534
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01638687
BCBS
IL
Enumeration date
01/04/2008
Last updated
08/07/2013
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