| Elizabeth A Larson Inc | |
|
6810 S Lyncrest Ave Suite 201 Sioux Falls SD 57108-2515 | |
| (605) 274-1119 | |
| (605) 271-9983 |
| Full Name | Elizabeth A Larson Inc |
|---|---|
| Speciality | Psychologist |
| Location | 6810 S Lyncrest Ave, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Elizabeth Anne Larson (PRESIDENT) |
| Authorized Official Contact | 6052741119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elizabeth A Larson Inc 6810 S Lyncrest Ave Suite 201 Sioux Falls SD 57108-2515 Ph: (605) 274-1119 | Elizabeth A Larson Inc 6810 S Lyncrest Ave Suite 201 Sioux Falls SD 57108-2515 Ph: (605) 274-1119 |
| NPI Number | 1144416447 |
|---|---|
| Provider Enumeration Date | 09/20/2007 |
| Last Update Date | 09/18/2008 |
| Medicare PECOS PAC ID | 9335186071 |
|---|---|
| Medicare Enrollment ID | O20050413001047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144416447 | NPI | - | NPPES |
| 102709 | Other | SD | HEALTH PARTNERS |
| 4905421 | Other | SD | UNITED BEHAVIORAL HEALTH |
| 455505000 | Other | SD | MAGELLON BEHAVIORAL HEALT |
| 4996486 | Other | SD | BLUE CROSS BLUE SHEILD |
| 6551970 | Medicaid | SD | |
| 9982 | Other | SD | MIDLANDS CHOICE |
| 22188 | Other | SD | SANFORD HEALTH |
| 7305 | Other | SD | AVERA HEALTH PLANS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | SD424 (South Dakota) | Primary |
| Provider Name | Elizabeth Anne Larson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649384801 PECOS PAC ID: 0840237582 Enrollment ID: I20050414000040 |
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