Individual
GRACE EVELYN LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPCC, LADC
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
PO BOX 860912, PROVIDER ENROLLMENT - RST, MINNEAPOLIS, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4442
MN
101YP2500X
Professional Counselor
—
—
Other
Enumeration date
06/03/2024
Last updated
01/27/2025
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