Individual provider Active NPI

Andrew John Larson, MS, LPCC, LADC

  • Mental Health Counselor
  • Maplewood, MN
National Provider Identifier
1134061096
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5535 Issued in MN
Practice address
2000 White Bear Ave N
Maplewood, MN 55109-3713
Phone
(651) 216-9361
NPI assigned
Apr 8, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5535 MN Primary

Addresses

Primary practice location

2000 White Bear Ave N
Maplewood, MN 55109-3713

Mailing address

14162 Dearborn Path
Rosemount, MN 55068-7123
Phone (651) 216-9361

Other practice location 1

1675 Beam Ave
Maplewood, MN 55109-1172
Phone (651) 216-9361

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
Master of Science

State licenses

LicenseStateTypeSpecialty
5535MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1134061096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14162 DEARBORN PATH",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550687123",
            "telephone_number": "651-216-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WHITE BEAR AVE N",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551093713",
            "telephone_number": "651-216-9361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Beam Ave",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551091172",
            "country_code": "US",
            "telephone_number": "651-216-9361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MS, LPCC, LADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "5535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.