Provider Demographics
NPI:1053034876
Name:FLINT, LARISSA (LCSW)
Entity type:Individual
Prefix:
First Name:LARISSA
Middle Name:
Last Name:FLINT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LARISSA
Other - Middle Name:
Other - Last Name:OVERTON FLINT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:271 W SHORT ST STE 508
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1214
Mailing Address - Country:US
Mailing Address - Phone:859-310-6505
Mailing Address - Fax:
Practice Address - Street 1:271 W SHORT ST STE 508
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1214
Practice Address - Country:US
Practice Address - Phone:859-310-6505
Practice Address - Fax:859-310-6505
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY257491104100000X
251B00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No251B00000XAgenciesCase Management