Provider Demographics
NPI:1538293964
Name:LARSEN, STEPHANIE SMEDLEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:SMEDLEY
Last Name:LARSEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22011 DAY STAR DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8356
Mailing Address - Country:US
Mailing Address - Phone:720-851-1284
Mailing Address - Fax:
Practice Address - Street 1:3263 FRASER ST STE 3
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-1245
Practice Address - Country:US
Practice Address - Phone:303-371-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical