Active NPI
Lonnie James Larrison, CO 61378037
- Addiction (Substance Use Disorder) Counselor
- Yakima, WA
National Provider Identifier
1205534831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- CO61378037
- Practice address
- 120 South 3Rd Street
Yakima, WA 98901-2875 - Phone
- (509) 248-1800
- NPI assigned
- Feb 22, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Peer Specialist | 175T00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO61378037 | WA | Primary |
Addresses
Primary practice location
120 South 3Rd Street
Yakima, WA 98901-2875
Mailing address
120 S 3Rd St
Yakima, WA 98901-2875
Phone (509) 248-1800
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 910755984 | Medicaid | WA | |
| 2235389 | Medicaid | WA |
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 |
|---|---|---|---|
| CO61378037 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yakima Valley Council on Alcoholism | Past | Accepting new patients |
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.
-
- Substance Abuse Rehabilitation Facility
- Buena, WA
- NPI 1588879928
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1677024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691020800000",
"number": "1205534831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S 3RD ST",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989012875",
"telephone_number": "509-248-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SOUTH 3RD STREET",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989012875",
"telephone_number": "509-248-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARRISON",
"first_name": "LONNIE",
"middle_name": "JAMES",
"credential": "CO 61378037",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-22",
"last_updated": "2023-08-03",
"certification_date": "2023-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WA",
"license": "CO61378037",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "910755984",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2235389",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yakima, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.