Provider Demographics
NPI:1003420597
Name:LARSON, JOSHUA A (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:A
Last Name:LARSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7322 W RAWSON AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8117
Mailing Address - Country:US
Mailing Address - Phone:414-266-3339
Mailing Address - Fax:414-433-9007
Practice Address - Street 1:7322 W RAWSON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8117
Practice Address - Country:US
Practice Address - Phone:414-266-3339
Practice Address - Fax:414-433-9007
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-02
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8120-125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health