Matthew G Larson PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

03609393501 Issued in UT

Legal business name

MATTHEW G LARSON PC

Practice address

24 S 600 E Ste 6
Salt Lake City, UT 84102-4201

Phone

(801) 521-0699

Fax

(801) 521-0688

NPI assigned

Feb 25, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Matthew G Larson, LCSWNPI 1326002437

Title

Owner

Phone

(801) 521-0699

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Tax ID family

Matt Larson Psychotherapy and Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Matt Larson Psychotherapy and Associates

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1942746060
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew G. Larson, LCSW

  • Clinical Social Worker
  • SLC, UT
  • NPI 1326002437
  Medicare reassignment NPD Authorized official
• Isabelle Briner, CPCI

  • Professional Counselor
  • Salt Lake City, UT
  • NPI 1417168378
  NPD (past)
• Juliann Marie Cook Jeppsen, LCSW

  • Clinical Social Worker
  • South Jordan, UT
  • NPI 1831475821
  NPD (past)
• Marvin Hamilton, LCSW

  • Clinical Social Worker
  • Salt Lake City, UT
  • NPI 1770991374
  NPD (past)
• Gina Gammon Searle, MA

  • Professional Counselor
  • Holladay, UT
  • NPI 1154390870
  NPD (past)

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

{
    "created_epoch": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1093984031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1221",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841014201",
            "telephone_number": "801-521-0699",
            "fax_number": "801-521-0688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 600 E STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841024201",
            "telephone_number": "801-521-0699",
            "fax_number": "801-521-0688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW G LARSON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-521-0699",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "03609393501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528330442001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matt Larson Psychotherapy and Associates
• Rano Naim Gabra Matta, MD
• Kristiana Matthes
• Matthew and David Dental PLLC
• Matthew Dianthony, Psy.D.
• Brenda Kelly Matthews, DNP
• Darius Matthews
• Henry Matthews
• Jennifer Susan Matthews
• Julie Mary Matthews

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.