Provider Demographics
NPI:1437808078
Name:LARSEN, CELESTE AIMEE (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:CELESTE
Middle Name:AIMEE
Last Name:LARSEN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CLUB HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-8073
Mailing Address - Country:US
Mailing Address - Phone:757-582-8147
Mailing Address - Fax:
Practice Address - Street 1:1320 CLUB HOUSE DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-8073
Practice Address - Country:US
Practice Address - Phone:757-582-8147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011302101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional