Amber Lee Larson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-22-2226 Issued in OR

Practice address

1 Serenity Lane, 91150 Coburg Industrial Way,
Coburg, OR 97408

Phone

(541) 687-1110

NPI assigned

Feb 1, 2023

Last updated

Feb 1, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1235835208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SERENITY LANE, 91150 COBURG INDUSTRIAL WAY,",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "97408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SERENITY LANE, 91150 COBURG INDUSTRIAL WAY,",
            "city": "COBURG",
            "state": "OR",
            "postal_code": "97408",
            "telephone_number": "541-687-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "AMBER",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-22-2226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Christine Kinser
• Hannah Kreeger
• Karen Lacy, MA
• Amy M Lamb, FNP
• Dallas Langley
• Kimberly Jean Lashley
• Patricia A Lawrence, MSN, FNP, PMHNP
• Jade Lee, RN
• John Walter Lee IV
• Theresa Mae Leonard

• Addiction (Substance Use Disorder) Counselor in Coburg, OR
• Providers in Coburg, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.