Provider Demographics
NPI:1689332280
Name:LARSON, KATHERINE (MMFT)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:LARSON
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 PURNELL DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5339
Mailing Address - Country:US
Mailing Address - Phone:615-592-6133
Mailing Address - Fax:
Practice Address - Street 1:609 W IRIS DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3120
Practice Address - Country:US
Practice Address - Phone:615-592-6133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist