Individual provider Active NPI

Nancy Jean Larson, LISW-S

  • Clinical Social Worker
  • Toledo, OH
National Provider Identifier
1235689118
Registry record updated Oct 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I-0004788 Issued in OH
Practice address
3335 Meijer Dr Ste 450
Toledo, OH 43617-3122
Phone
(419) 324-0334
Fax
(707) 653-8400
NPI assigned
Oct 4, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I-0004788 OH Primary

Addresses

Primary practice location

3335 Meijer Dr Ste 450
Toledo, OH 43617-3122

Mailing address

3335 Meijer Dr Ste 450
Toledo, OH 43617-3122
Phone (419) 324-0334

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

LicenseStateTypeSpecialty
I-0004788OHMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1475539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475539200000",
    "number": "1235689118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 MEIJER DR STE 450",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436173122",
            "telephone_number": "419-324-0334",
            "fax_number": "707-653-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 MEIJER DR STE 450",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436173122",
            "telephone_number": "419-324-0334",
            "fax_number": "707-653-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NANCY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-04",
        "last_updated": "2016-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I-0004788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.