Provider Demographics
NPI:1851265870
Name:LARIMORE, BRIAN M (MSW)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:M
Last Name:LARIMORE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 KENNETH DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61704-2587
Mailing Address - Country:US
Mailing Address - Phone:309-222-8315
Mailing Address - Fax:309-777-6077
Practice Address - Street 1:205 N WILLIAMSBURG DR STE A&B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-7706
Practice Address - Country:US
Practice Address - Phone:309-222-8315
Practice Address - Fax:309-777-6066
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-02
Last Update Date:2025-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.117660104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker