Individual provider Active NPI

Larry Carl Willett, PHD LPC

  • Marriage & Family Therapist
  • Greensboro, NC
National Provider Identifier
1073605440
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1002 Issued in NC
Practice address
600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7722
Phone
(336) 292-1510
Fax
(336) 292-0679
NPI assigned
Sep 29, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1002 NC
Marriage & Family Therapist 106H00000X 1002 NC Primary

Addresses

Primary practice location

600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7722

Mailing address

600 Green Valley Rd
Suite 204
Greensboro, NC 27408-7722
Phone (336) 292-1510

Other identifiers 3

IdentifierTypeStateIssuer
09347900OtherMAGELLA BEH HEALTH
6102901MedicaidNC
87441OtherNCBCBS

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

State licenses

LicenseStateTypeSpecialty
1002NCMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Crossroads Psychiatric Group, PA Mental Health Past Accepting new patients
Moses Cone Affiliated Physicians, Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1073605440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087722",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GREEN VALLEY RD",
            "address_2": "SUITE 204",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087722",
            "telephone_number": "336-292-1510",
            "fax_number": "336-292-0679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLETT",
        "first_name": "LARRY",
        "middle_name": "CARL",
        "credential": "PHD LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "1002",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLA BEH HEALTH",
            "identifier": "09347900",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102901",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "87441",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.