Individual
STEPHANIE LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW, LCSW
Contact information
Practice address
1186 121ST ST, ROBERTS, WI 54023-8538
(715) 495-5486
Mailing address
1186 121ST ST, ROBERTS, WI 54023-8538
(715) 495-5486
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11038-123
WI
1041C0700X
Clinical Social Worker
29282
MN
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/03/2021
Last updated
05/06/2026
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