Individual provider Active NPI

Kelsey Anne Larsh

  • Behavior Analyst
  • Honolulu, HI
National Provider Identifier
1124789300
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BA-753 Issued in HI
Practice address
500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902
Phone
(808) 501-1300
Fax
(855) 892-0299
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-21-53254
Behavior Analyst 103K00000X BA-753 HI Primary

Addresses

Primary practice location

500 Ala Moana Blvd Ste 7400
Honolulu, HI 96813-4902

Mailing address

507 Walnut St
Three Rivers, MI 49093-1433
Phone (269) 535-0438

Other practice location 1

2675 Court Dr # B
Gastonia, NC 28054-1478
Phone (704) 824-4999

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

State licenses

LicenseStateTypeSpecialty
BA-753HIMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1124789300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 WALNUT ST",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490931433",
            "telephone_number": "269-535-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 7400",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134902",
            "telephone_number": "808-501-1300",
            "fax_number": "855-892-0299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2675 Court Dr # B",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280541478",
            "country_code": "US",
            "telephone_number": "704-824-4999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSH",
        "first_name": "KELSEY",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-21-53254",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "HI",
            "license": "BA-753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.