Provider Demographics
NPI:1326770587
Name:LARSON, JOSHUA (MSW)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:LARSON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2858 W 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:KS
Mailing Address - Zip Code:67042-3062
Mailing Address - Country:US
Mailing Address - Phone:316-648-2893
Mailing Address - Fax:
Practice Address - Street 1:8100 E 22ND ST N STE 2200-3
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2313
Practice Address - Country:US
Practice Address - Phone:316-347-7157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker