Individual
BRETT KEVIN LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
344 E 100 S STE 301, SALT LAKE CITY, UT 84111-1727
(801) 428-4257
Mailing address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-5000
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
10516521-3501
UT
1041C0700X
Clinical Social Worker
76799
CA
Other
Enumeration date
09/13/2013
Last updated
05/16/2022
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