Steve Mark Larsen, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

36884 Issued in TX

Practice address

1507 W Main St
Gatesville, TX 76528-1024

Phone

(254) 865-8251

NPI assigned

Mar 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1142640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1083673123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W MAIN ST",
            "city": "GATESVILLE",
            "state": "TX",
            "postal_code": "765281024",
            "telephone_number": "254-865-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "STEVE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-18",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NV",
            "license": "PY0466",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSING BOARD",
            "identifier": "36884",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503261",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Nicole Kilgore
• Carl John Kornman, MD
• Natalie Joy Kortis, PA
• Madeleine Danielle Lamar, COTA
• Brooke Therese' Lamartina, LPC
• Melanie Amber Laster
• Jo Ann Ocbena Laughrin
• Christopher Jason Long, DO
• M Bello, OD., P.C.
• Pragna Malkaram

• Clinical Psychologist in Gatesville, TX
• Providers in Gatesville, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; 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.