Individual
SAMANTHA MARIE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
2345 CANTERBURY LN, SISTER BAY, WI 54234-5602
(920) 868-3511
(608) 270-0467
Mailing address
323 S 18TH AVE, STURGEON BAY, WI 54235-1401
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
131979-121
WI
1041C0700X
Clinical Social Worker
Primary
11314-123
WI
Other
Enumeration date
07/30/2020
Last updated
01/16/2026
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