Kenneth A Larsen, DMIN, PHD, ABMP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY2944MA Issued in MA

Practice address

34 N Eldorado Ave
Bozeman, MT 59718-1229

Phone

(617) 413-2328

Fax

(617) 334-7845

NPI assigned

Jul 6, 2006

Last updated

Oct 7, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Interoperability endpoints

• Direct secure messaging: kennethlarsenphd.kennethlarsen@160150.advancedmd-direct.com
• Direct secure messaging: klarsen254908@direct.bilh.masshiway.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1053343707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 N ELDORADO AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597181229",
            "telephone_number": "617-413-2328",
            "fax_number": "617-334-7845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 N ELDORADO AVE",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597181229",
            "telephone_number": "617-413-2328",
            "fax_number": "617-334-7845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 Victory Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "MA",
            "postal_code": "021713132",
            "country_code": "US",
            "telephone_number": "617-413-2328",
            "fax_number": "617-334-7845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMIN, PHD, ABMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "PSY2944MA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thad Langford, DDS
• Elizabeth Langley, LCSW
• Christine Benedict Laramee, PA
• Deanna Largess
• Ashley Marie Larsen
• Ryan James Larsen
• Elizabeth Larson, PHD
• Kimberly Rae Larson, MS, RD, LN
• Matt Lasalle
• Nicole Laska, D.C.

• Clinical Psychologist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Clinical Psychologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.