Provider Demographics
NPI:1295774834
Name:LARSON, INGA KAREN (LCSW)
Entity type:Individual
Prefix:MS
First Name:INGA
Middle Name:KAREN
Last Name:LARSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 KALAMATH ST
Mailing Address - Street 2:107
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-3949
Mailing Address - Country:US
Mailing Address - Phone:303-459-4776
Mailing Address - Fax:
Practice Address - Street 1:3035 W 25TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-4635
Practice Address - Country:US
Practice Address - Phone:303-459-4776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical