Individual provider Active NPI

Robert M Larson, LCSW

  • Clinical Social Worker
  • Bay Pines, FL
National Provider Identifier
1003078155
Registry record updated Nov 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071056 Issued in NY
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

Updated by the provider on Nov 28, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
071056NYMDClinical 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.

Verify at the official NPI Registry.