Active NPI
Robert M Larson, LCSW
- Clinical Social Worker
- Bay Pines, FL
National Provider Identifier
1003078155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 071056
- Practice address
- 10000 Bay Pines Blvd
Bay Pines Vahcs
Bay Pines, FL 33744 - Phone
- (727) 398-6661
- Fax
- (727) 398-9567
- NPI assigned
- Jun 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 071056 | NY | Primary |
Addresses
Primary practice location
10000 Bay Pines Blvd
Bay Pines Vahcs
Bay Pines, FL 33744
Mailing address
10000 Bay Pines Blvd
Bay Pines Vahcs
Bay Pines, FL 33744
Phone (727) 398-6661
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071056 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1448668800000",
"number": "1003078155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10000 BAY PINES BLVD",
"address_2": "BAY PINES VAHCS",
"city": "BAY PINES",
"state": "FL",
"postal_code": "33744",
"telephone_number": "727-398-6661",
"fax_number": "727-398-9567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 BAY PINES BLVD",
"address_2": "BAY PINES VAHCS",
"city": "BAY PINES",
"state": "FL",
"postal_code": "33744",
"telephone_number": "727-398-6661",
"fax_number": "727-398-9567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "ROBERT",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-30",
"last_updated": "2015-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "071056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bay Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.