Provider Demographics
NPI:1437044237
Name:LARSON, DANIELLE RODRIGUES (LPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RODRIGUES
Last Name:LARSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 CEDARWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HORIZON CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79928-8437
Mailing Address - Country:US
Mailing Address - Phone:915-208-0874
Mailing Address - Fax:
Practice Address - Street 1:14843 ENERGY WAY
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-5757
Practice Address - Country:US
Practice Address - Phone:952-209-1644
Practice Address - Fax:952-423-0365
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3126101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health