Jenna Lynn Larson

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1517 Highway 13 E
Burnsville, MN 55337-2917

Phone

(612) 237-1750

NPI assigned

Oct 22, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1729555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729900800000",
    "number": "1215758172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7211 CREEKWOOD LN",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553722211",
            "telephone_number": "612-685-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 HIGHWAY 13 E",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372917",
            "telephone_number": "612-237-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "JENNA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-22",
        "last_updated": "2024-10-26",
        "certification_date": "2024-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "307046",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Andrew Lanyon
• Daniel Joseph Larrabee, MA, BCBA
• Amy Larsen
• Edward Vladmir Larson, JD
• Emily Marie Larson
• Linda Larson, PTA
• Eric Latour
• Stephanie Latshaw
• Erica Renee Laub, MSW, LICSW
• Nicole Marie Lauer, D.C.

• Behavior Technician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2024; 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.