MARY JO LAROSE LCSW NPI 1275952012

NPI Information

NPI: 1275952012
Provider Name: MARY JO LAROSE, LCSW
Classification: Counselor - 101Y00000X
Entity Type: Individual
Address:
710 FRANKLIN ST STE 200
MICHIGAN CITY, IN
ZIP 46360
Phone: (219) 872-6200
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Mary Jo Larose, LCSW is a counselor in Michigan City, IN. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Mary Jo Larose, LCSW NPI is 1275952012. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

710 FRANKLIN ST STE 200
MICHIGAN CITY, IN
ZIP 46360-564
Phone: (219) 872-6200
Fax: (219) 879-2915

The enumeration date for this NPI number is 4/9/2014 and was last updated on 4/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101Y00000X	Counselor		34006321A	INDIANA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	34006321A	OTHER	INDIANA	LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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