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Individual

CHAD WILLIAM LARSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW, CSAC, ICS

Contact information

Practice address
6900 N PECOS RD, N LAS VEGAS, NV 89086-4400
(027) 791-9000
Mailing address
5005 N PIEDRAS ST, ATTENTION WBAMC, EL PASO, TX 79920-5002
(915) 742-6382
(915) 569-4890

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
8300-123
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15442-134
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15603-132
WI
1041C0700X
Clinical Social Worker
Primary
8300-123
WI

Other

Enumeration date
10/29/2015
Last updated
01/23/2024
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