Doctor Name: | MR. PHILLIP ERNEST LARKINS |
NPI Number: | 1003262817 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSW - LICSW |
License Number: | 1975 |
Business Practice Address: | 10066 Toledo Dr N Brooklyn Park, MN - 554432378 |
Business Phone Number: | 6129916050 |
Business Fax Number: | |
Mailing Address: | 10066 Toledo Dr N, BROOKLYN PARK |
State: | MN |
Postal Code: | 554432378 |
Phone Number: | 6129916050 |
Fax Number: | |
NPI Enumeration Date: | 05/11/2016 |
NPI Last Update Date: | 05/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1975 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |