Individual
RENAE CARRIE LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, LIMHP
Contact information
Practice address
508 S MAIN ST, COUNCIL BLUFFS, IA 51503-6507
(712) 352-2110
(712) 352-1688
Mailing address
508 S MAIN ST, COUNCIL BLUFFS, IA 51503-6507
(402) 250-9366
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
092299
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510769
—
IA
Enumeration date
12/19/2018
Last updated
07/13/2023
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