Provider Demographics
NPI:1558700120
Name:LARSON, ERIC CHRISTOPHER (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:CHRISTOPHER
Last Name:LARSON
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 WILSON ROAD, SUITE 320
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55424
Mailing Address - Country:US
Mailing Address - Phone:952-405-6093
Mailing Address - Fax:952-500-9503
Practice Address - Street 1:5200 WILSON ROAD, SUITE 320
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55424
Practice Address - Country:US
Practice Address - Phone:952-405-6093
Practice Address - Fax:952-500-9503
Is Sole Proprietor?:No
Enumeration Date:2013-06-17
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN196471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical