Annette Marie Larson, M.A., L.P.C., LADC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

01859 Issued in MN

Practice address

199 Coon Rapids Blvd NW
Suite 310
Coon Rapids, MN 55433-5831

Phone

(763) 785-8111

Fax

(763) 785-8111

NPI assigned

Jun 5, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Northtown Psychology Associates LLC

  • Psychologist
  • Coon Rapids, MN
  • NPI 1174573067
  NPD (past)

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

{
    "created_epoch": "1465084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465084800000",
    "number": "1174972715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 92ND DR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496851",
            "telephone_number": "763-444-1321",
            "fax_number": "763-785-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW",
            "address_2": "SUITE 310",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335831",
            "telephone_number": "763-785-8111",
            "fax_number": "763-785-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "ANNETTE",
        "middle_name": "MARIE",
        "credential": "M.A., L.P.C., LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-05",
        "last_updated": "2016-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "303923",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "01859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF BEHAVIORAL HEALTH AND THERAPY,LICENSED PROFESSIONAL COUNSELOR",
            "identifier": "01859",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CERTIFICATION BOARD, ALCOHOL AND DRUG COUNSELOR-MINNESOTA",
            "identifier": "7078",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA BOARD OF BEHAVIORAL HEALTH AND THERAPY, ALCOHOL AND DRUG COUNSELOR",
            "identifier": "303923",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Langewisch, BAS, LADC
• Korina Lynn Lantz
• Kyle Emery Lapointe, P.T.
• Madisyn Larkey
• Damontae Maurice Larkin
• Kara Diane Larson, MD
• Kelly Larson
• Kiran K Lassi, M.D.
• Joshua Paul Latimer
• Noel Laudi, M.D.

• Mental Health Counselor in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2016; 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.