Individual provider Active NPI

Larry Kroll, PH.D.

  • Clinical Psychologist
  • Ft Belvoir, VA
National Provider Identifier
1063612299
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
805 Issued in SC
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

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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.

Verify at the official NPI Registry.