Provider Demographics
NPI:1821538521
Name:GARSKI, LARISA ANN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:LARISA
Middle Name:ANN
Last Name:GARSKI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 BRYANT AVE S STE 108
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2332
Mailing Address - Country:US
Mailing Address - Phone:651-206-4064
Mailing Address - Fax:
Practice Address - Street 1:155 N MICHIGAN AVE STE 325
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7591
Practice Address - Country:US
Practice Address - Phone:651-764-7277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
MN3411106H00000X
IL166.001122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist