| Provider / Organization | NPI | Date Certified |
|---|---|---|
| WILLIAM LARRY | 1568061927 | 2020-10-18 |
William Larry is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1568061927. Registration indicates William Larry is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | William Larry MS |
| Practice Office Address | 2600 OAKLAND AVE ELKHART, IN US |
| Practice Office Telephone | 5745331234 |
| Practice Office Fax | 5745372652 |
| Mailing Address | PO BOX 809 GOSHEN, IN 465270809 US |
| Business Telephone | 5745331234 |
| Business Fax | 5745372652 |
| Code | Practice | License No State |
|---|---|---|
| 101Y00000X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor Behavioral Health/Substance Abuse/Psychiatry Counselor Behavioral Health & Social Service Providers |