Individual
LORI M LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, LPC, MAC, ACS
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 240-6560
Mailing address
650 HUEBNER RD, FT RILEY, KS 66442-4030
(785) 240-6560
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P401
NE
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
1080
NE
101YP2500X
Professional Counselor
1954
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025224900
—
NE
05
—
10025315600
—
NE
05
—
47037661202
—
NE
Enumeration date
11/27/2006
Last updated
02/01/2023
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