Provider Demographics
NPI:1104235779
Name:LARSON, JOYCE
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:
Last Name:LARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8234 MOSS CIR
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80007-6717
Mailing Address - Country:US
Mailing Address - Phone:316-655-2971
Mailing Address - Fax:
Practice Address - Street 1:1190 S LASHLEY LN
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305
Practice Address - Country:US
Practice Address - Phone:316-655-2971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2018-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2586106H00000X
COMFTC.0013765106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist