Larissa Marie Didriksen, LCSW is a
Social Worker - Clinical based in Richmond, Illinois. Larissa Marie Didriksen is licensed to practice in Illinois (license number 149010221) and her current practice location is
9716 Us Highway 12, Richmond, Illinois. She can be reached at her office (for appointments etc.) via phone at
(815) 581-8131.
NPI number for Larissa Marie Didriksen is 1790243756 and her current mailing address is W1037 Aralia Rd, Genoa City, Wisconsin. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1790243756.
Healthcare Provider's Profile
| Full Name | Larissa Marie Didriksen |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 9716 Us Highway 12, Richmond, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1790243756
- Provider Enumeration Date: 03/08/2019
- Last Update Date: 10/09/2019
Medical Identifiers
Medical identifiers for Larissa Marie Didriksen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1790243756 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 149010221 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larissa Marie Didriksen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Larissa Marie Didriksen, LCSW W1037 Aralia Rd, Genoa City, WI 53128-1574 Ph: (262) 208-0078 | Larissa Marie Didriksen, LCSW 9716 Us Highway 12, Richmond, IL 60071-9253 Ph: (815) 581-8131 |
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