Active NPI
Kelli Downs Larson, LCPC
- Professional Counselor
- Missoula, MT
National Provider Identifier
1275774499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1397
- Practice address
- 210 N Higgins Ave
Suite 320
Missoula, MT 59802-4462 - Phone
- (406) 241-8213
- NPI assigned
- Mar 18, 2009
- Last updated
- Mar 26, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 1397 | MT | Primary |
Addresses
Primary practice location
210 N Higgins Ave
Suite 320
Missoula, MT 59802-4462
Mailing address
PO Box 16581
Missoula, MT 59808-6581
Phone (406) 241-8213
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250619001726 | MT | Practitioner - Mental Health Counselor | 2961913538 | Practice locations: Missoula, MT |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
101 E Broadway St
Suite 310
Missoula, MT 59802-4588
Phone (406) 241-8213
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1397 | MT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269561600000",
"number": "1275774499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16581",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598086581",
"telephone_number": "406-241-8213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N HIGGINS AVE",
"address_2": "SUITE 320",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598024462",
"telephone_number": "406-241-8213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "KELLI",
"middle_name": "DOWNS",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-18",
"last_updated": "2010-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "1397",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.