Madelyn Audrey Larsin, LISCW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

30114 Issued in MN

Practice address

5125 County Road 101 Ste 300
Minnetonka, MN 55345-4157

Phone

(952) 932-7277

Fax

(952) 932-9827

NPI assigned

Oct 24, 2023

Last updated

May 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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 MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Relate Inc

  dba Relate

  • Community/Behavioral Health Agency
  • Minnetonka, MN
  • NPI 1053486902
  Medicare reassignment NPD

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

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1063284974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101 STE 300",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454157",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 COUNTY ROAD 101 STE 300",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454157",
            "telephone_number": "952-932-7277",
            "fax_number": "952-932-9827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSIN",
        "first_name": "MADELYN",
        "middle_name": "AUDREY",
        "credential": "LISCW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "30114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Lange
• Adam James Lanners, DPT, PT
• Bridget Ann Lanz
• Mario Antonio Lanzas, ARNP
• Krista Laplant, M.A.
• Annalise Larson
• Christine Marie Larson, M.D.
• Kathleen M Larson, M.D.
• Kimberly Larson
• Mark Larson, RPH

• Clinical Social Worker in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.