Provider Demographics
NPI:1891858031
Name:LARSEN, CLARE ANGELA (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:ANGELA
Last Name:LARSEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 7TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-4052
Mailing Address - Country:US
Mailing Address - Phone:507-289-2100
Mailing Address - Fax:507-289-2100
Practice Address - Street 1:2116 CAMPUS DR SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-4713
Practice Address - Country:US
Practice Address - Phone:507-281-6248
Practice Address - Fax:507-281-7392
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical