Provider Demographics
NPI:1669609020
Name:LARSEN, FRANKIE DIANE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:FRANKIE
Middle Name:DIANE
Last Name:LARSEN
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 1:7665 CUSTER RD
Mailing Address - Street 2:
Mailing Address - City:FRUITLAND
Mailing Address - State:ID
Mailing Address - Zip Code:83619-5039
Mailing Address - Country:US
Mailing Address - Phone:208-271-9362
Mailing Address - Fax:208-271-9262
Practice Address - Street 1:7665 CUSTER RD
Practice Address - Street 2:
Practice Address - City:FRUITLAND
Practice Address - State:ID
Practice Address - Zip Code:83619-5039
Practice Address - Country:US
Practice Address - Phone:208-271-9362
Practice Address - Fax:208-271-9262
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL48381041C0700X
IDLCSW-379051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical