Provider Demographics
NPI:1073123568
Name:LARNED, ANN G
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:G
Last Name:LARNED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 STONEYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-1418
Mailing Address - Country:US
Mailing Address - Phone:914-319-3230
Mailing Address - Fax:
Practice Address - Street 1:670 WHITE PLAINS RD PH
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5024
Practice Address - Country:US
Practice Address - Phone:914-319-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-09
Last Update Date:2020-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023333103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical