Mary Larson is a Clinical in Evanston, Illinois. Mary Larson practices all healthcare services and medical treatments related to Clinical. The NPI Number for Mary Larson is 1114030574. The last update date is 2007-07-08.
Mary Larson's current location address is 1830 Sherman Ave, Evanston, Illinois. You can contact this provider via phone number 8478666621 and fax number 8478640948. The mailing address for Mary Larson is 1830 Sherman Ave, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary Larson |
|---|---|
| Address | 1830 Sherman Ave, Evanston, Illinois |
| Phone Number | 8478666621 |
| Fax Number | 8478640948 |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1114030574 |
|---|---|
| Provider Enumeration Date | 2006-08-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1830 Sherman Ave |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 602013798 |
| Phone Number | 8478666621 |
| Fax Number | 8478640948 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Mary Larson by the Centers for Medicare & Medicaid Services (CMS)?
The Mary Larson has been assigned the NPI (National Provider Identifier) 1114030574. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Mary Larson's physical address?
The Mary Larson is physically located at 1830 Sherman Ave, in the city of Evanston, IL, with the postal code 602013798.
What is Mary Larson's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Mary Larson is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1114030574 to Mary Larson?
The Mary Larson received its 1114030574 assignment from the Centers for Medicare & Medicaid Services on 2006-08-17.
As of what date was the information regarding Mary Larson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mary Larson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.