Provider Demographics
NPI:1447982970
Name:LARKINS, MICHAEL A (CASAC-2,DOT SAP)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:LARKINS
Suffix:
Gender:M
Credentials:CASAC-2,DOT SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 APPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SWIFTWATER
Mailing Address - State:PA
Mailing Address - Zip Code:18370-7701
Mailing Address - Country:US
Mailing Address - Phone:917-420-7531
Mailing Address - Fax:
Practice Address - Street 1:180 APPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SWIFTWATER
Practice Address - State:PA
Practice Address - Zip Code:18370-7701
Practice Address - Country:US
Practice Address - Phone:917-420-7531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)