Provider Demographics
NPI:1760188080
Name:LARKE, LA-TOYA V (LMSW)
Entity Type:Individual
Prefix:
First Name:LA-TOYA
Middle Name:V
Last Name:LARKE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1379
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-5579
Mailing Address - Country:US
Mailing Address - Phone:267-917-0334
Mailing Address - Fax:
Practice Address - Street 1:2817 LILLIAN AVE
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-4334
Practice Address - Country:US
Practice Address - Phone:267-917-0334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-07
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW127362104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker