Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Larry Vaughn Blair, LICSW

Individual provider Clinical Social Worker · NPI 1083936181

Larry Vaughn Blair, LICSW is a Clinical Social Worker in Burnsville, Minnesota. Licensed in Minnesota. Registered with an NPI since 2010.

Licensed in
MN
In the registry since
2010
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

2970 Judicial Rd Ste 100
Burnsville, MN 55337
Phone: (952) 224-8990
Fax: (952) 224-8991
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 10727 (MN)

Record details

NPI number1083936181
Entity typeIndividual (Type 1)
GenderMale
Credentials LICSW
Sole proprietorNo
NPI enumeratedFebruary 17, 2010
Last updated in NPPESSeptember 25, 2024
Certification dateDecember 30, 2020

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