Active NPI
Jenelle D Larson, LMFT
- Marriage & Family Therapist
- Auburn, WA
National Provider Identifier
1154643310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF 60194305
- Practice address
- 816 F St SE
Auburn, WA 98002-6121 - Phone
- (253) 939-2202
- Fax
- (253) 735-1894
- NPI assigned
- Feb 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LF 60194305 | WA | Primary |
Addresses
Primary practice location
816 F St SE
Auburn, WA 98002-6121
Mailing address
5417 James PL SE
Auburn, WA 98092-3855
Phone (805) 331-0867
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
| License | State | Type | Specialty |
|---|---|---|---|
| LF 60194305 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301961600000",
"number": "1154643310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5417 JAMES PL SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980923855",
"telephone_number": "805-331-0867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 F ST SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980026121",
"telephone_number": "253-939-2202",
"fax_number": "253-735-1894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "JENELLE",
"middle_name": "D",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-15",
"last_updated": "2011-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF 60194305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.