Provider Demographics
NPI:1255980280
Name:LARSON, REMI MEGAN CHRISTINE (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:REMI
Middle Name:MEGAN CHRISTINE
Last Name:LARSON
Suffix:
Gender:F
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:CHRISTINE
Other - Last Name:LARSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 56553
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91413-1553
Mailing Address - Country:US
Mailing Address - Phone:310-439-9780
Mailing Address - Fax:
Practice Address - Street 1:611 S KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-2319
Practice Address - Country:US
Practice Address - Phone:310-439-9780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program