Jennifer Kathryn Larson, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

4255 Pheasant Ridge Dr NE Ste 412
Blaine, MN 55449-5066

Phone

(763) 703-3754

Fax

(372) 703-3725

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hope Rising

  • Marriage & Family Therapist
  • New Brighton, MN
  • NPI 1295292753
  Medicare reassignment NPD

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1144702622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "763-703-3754",
            "fax_number": "372-703-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 PHEASANT RIDGE DR NE STE 412",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554495066",
            "telephone_number": "763-703-3754",
            "fax_number": "372-703-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNIFER",
        "middle_name": "KATHRYN",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Lamers, LAMFT
• Kelly Anne Tikkanen Lang, DDS
• Mary M Laplant, PHARMD
• Daniel Larscheid, DDS
• Shelly Lea Larson-Peters, M.D.
• Sarah Rose Latterell, D.D.S.
• Angela Laughlin, APRN, NP-C
• David Karmue Lawor Jr., RN, BSN,CCRN
• Jean L Layman, O.D.
• Richard Leach, M.D.

• Marriage & Family Therapist in Blaine, MN
• Providers in Blaine, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.