Individual ProviderLarissa WeldSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3283 122nd Ave, Allegan, MI 49010-9511(269) 673-6617(269) 568-5572PECOS EnrollmentBased on the most recent information from CMS, provider Larissa Weld does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1770056095Provider TypeIndividualFull NameWeld, LarissaGenderFemaleSole ProprietorNoEnumeration Date1/9/2019Last Updated1/9/2019Contact InformationPractice LocationPractice Address3283 122nd Ave, Allegan, MI 49010-9511Phone(269) 673-6617FaxUnlisted FaxMailing LocationMailing Address115 E Maple St, Kalamazoo, MI 49001-2830Phone(269) 568-5572FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense6801103102Michigan