Active NPI
Jessica Larsen, PH.D.
- Clinical Psychologist
- Hoboken, NJ
National Provider Identifier
1083068480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5659
- Practice address
- 501 9TH St Apt 511
Hoboken, NJ 07030-2187 - Phone
- (646) 498-0997
- NPI assigned
- Apr 21, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1261 | OK | |
| Clinical Psychologist | 103TC0700X | 5659 | NJ | Primary |
| Clinical Psychologist | 103TC0700X | 21856 | NY |
Addresses
Primary practice location
501 9TH St Apt 511
Hoboken, NJ 07030-2187
Mailing address
501 9TH St Apt 511
Hoboken, NJ 07030-2187
Phone (646) 498-0997
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5659 | NJ | MD | Clinical Psychologist |
| 21856 | NY | MD | Clinical Psychologist |
| 1261 | OK | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494374400000",
"number": "1083068480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 9TH ST APT 511",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070302187",
"telephone_number": "646-498-0997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 9TH ST APT 511",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070302187",
"telephone_number": "646-498-0997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "JESSICA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-21",
"last_updated": "2017-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OK",
"license": "1261",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NJ",
"license": "5659",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "21856",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hoboken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.