Provider Demographics
NPI:1326259565
Name:LARSON, JAMES H (LPC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:H
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 1:1632 CHOTEAU CIR
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2749
Mailing Address - Country:US
Mailing Address - Phone:817-488-2841
Mailing Address - Fax:
Practice Address - Street 1:1632 CHOTEAU CIR
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-2749
Practice Address - Country:US
Practice Address - Phone:817-488-2841
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-26
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17915101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor