Provider Demographics
NPI:1255848511
Name:LARSEN, HAROLD STEPHEN (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:STEPHEN
Last Name:LARSEN
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:H.
Other - Middle Name:STEPHEN
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:310 RIVER ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-3080
Mailing Address - Country:US
Mailing Address - Phone:845-658-8083
Mailing Address - Fax:845-658-3874
Practice Address - Street 1:310 RIVER ROAD EXT
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-3080
Practice Address - Country:US
Practice Address - Phone:845-658-8083
Practice Address - Fax:845-658-3874
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002944-1103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling