Active NPI
Larry Kroll, PH.D.
- Clinical Psychologist
- Ft Belvoir, VA
National Provider Identifier
1063612299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 805
- Practice address
- 9300 Dewitt Loop
Ft Belvoir, VA 22060-5285 - Phone
- (907) 377-3071
- NPI assigned
- Jul 25, 2007
- 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 Psychologist | 103TC0700X | 805 | SC | Primary |
Addresses
Primary practice location
9300 Dewitt Loop
Ft Belvoir, VA 22060-5285
Mailing address
9300 Dewitt Loop
Ft Belvoir, VA 22060-5285
Other practice location 1
2630 Central Ave
354 Mdos/Sgoh
Eielson AFB, AK 99702-2301
Phone (907) 377-3071
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1063612299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FT BELVOIR",
"state": "VA",
"postal_code": "220605285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FT BELVOIR",
"state": "VA",
"postal_code": "220605285",
"telephone_number": "907-377-3071"
}
],
"practiceLocations": [
{
"address_1": "2630 Central Ave",
"address_2": "354 MDOS/SGOH",
"address_purpose": "LOCATION",
"city": "Eielson AFB",
"state": "AK",
"postal_code": "997022301",
"country_code": "US",
"telephone_number": "907-377-3071",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KROLL",
"first_name": "LARRY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-25",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "SC",
"license": "805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ft Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.