Provider Demographics
NPI:1679052955
Name:LARSSON, ELIZABETH CATHERINE CASEY (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CATHERINE CASEY
Last Name:LARSSON
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 1:224 SPRINGCREEK DR
Mailing Address - Street 2:
Mailing Address - City:IONE
Mailing Address - State:CA
Mailing Address - Zip Code:95640-9660
Mailing Address - Country:US
Mailing Address - Phone:630-336-1860
Mailing Address - Fax:
Practice Address - Street 1:224 SPRINGCREEK DR
Practice Address - Street 2:
Practice Address - City:IONE
Practice Address - State:CA
Practice Address - Zip Code:95640-9660
Practice Address - Country:US
Practice Address - Phone:630-336-1860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1084531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical