Active NPI
Astrid Larsen, PHD, LCPC, MBA
- Counselor
- Woodstock, IL
National Provider Identifier
1073114088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 180.007276
- Practice address
- 2317 Timberline TRL
Woodstock, IL 60098-8759 - Phone
- (847) 553-7764
- NPI assigned
- Nov 5, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 180.007276 | IL | Primary |
Addresses
Primary practice location
2317 Timberline TRL
Woodstock, IL 60098-8759
Mailing address
2317 Timberline TRL
Woodstock, IL 60098-8759
Phone (847) 553-7764
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
- Master of Business Administration, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180.007276 | IL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604534400000",
"number": "1073114088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2317 TIMBERLINE TRL",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600988759",
"telephone_number": "847-553-7764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2317 TIMBERLINE TRL",
"city": "WOODSTOCK",
"state": "IL",
"postal_code": "600988759",
"telephone_number": "847-553-7764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "ASTRID",
"name_prefix": "Dr.",
"credential": "PHD, LCPC, MBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-05",
"last_updated": "2020-11-05",
"certification_date": "2020-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "180.007276",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodstock, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.