Ruth Allison Larson, LMHC

Individual provider Active NPI Professional Counselor · Erieville, NY

NPI 1164583407 · NPPES record last updated May 29, 2025

Key facts

NPI
1164583407
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
007684 (NY)
Practice address
3455 Erieville Rd.
Erieville, NY 13061-1760
Phone
(315) 503-3112
Fax
(208) 888-3018
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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

Medicare Care Compare profile

Specialty
Mental Health Counselor
Education
Other, 1993
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

217 Ruth St
Minoa, NY 13116-1719

PO Box
Suite 203
Fayetteville, NY 13066

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251024002525 NY Practitioner - Mental Health Counselor 6406344928 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
007684NYMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ruth a. Larson, Licensed Mental Health Counselor, PLLC Professional Current
since Sep 6, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 007684 NY Yes

Addresses

Primary practice location

3455 Erieville Rd.
Erieville, NY 13061-1760

Mailing address

PO Box 203
Fayetteville, NY 13066-9998
Phone (315) 503-3112

Other identifiers

IdentifierTypeStateIssuer
DY1IMedicaidNY

Other providers in Erieville, NY

All providers in Erieville, NY · Professional Counselor in New York

Sources for this page

Verify at the official NPI Registry.