| Doctor Name: | DR. RICHARD GIRARD LARSON |
| NPI Number: | 1043286370 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | 180003363 |
| Business Practice Address: | 1039 College Ave. Ste. F Wheaton, IL - 60187 |
| Business Phone Number: | 3315512224 |
| Business Fax Number: | 8156424304 |
| Mailing Address: | 719 Lynwood Lane, WHEATON |
| State: | IL |
| Postal Code: | 601896308 |
| Phone Number: | 3315512224 |
| Fax Number: | 8156424304 |
| NPI Enumeration Date: | 02/27/2006 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180003363 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |