Provider Demographics
NPI:1598252983
Name:LARRABEE, TERESA A (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:A
Last Name:LARRABEE
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:ANN
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9352 HAKKILA RD
Mailing Address - Street 2:
Mailing Address - City:ANGORA
Mailing Address - State:MN
Mailing Address - Zip Code:55703-8002
Mailing Address - Country:US
Mailing Address - Phone:218-410-0600
Mailing Address - Fax:
Practice Address - Street 1:9352 HAKKILA RD
Practice Address - Street 2:
Practice Address - City:ANGORA
Practice Address - State:MN
Practice Address - Zip Code:55703-8002
Practice Address - Country:US
Practice Address - Phone:218-410-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-20
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN244991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical