Active NPI
Larson Sholander, PHD
- Psychologist
- Ann Arbor, MI
National Provider Identifier
1306331517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6351004399
- Practice address
- 2610 W Liberty St
Ann Arbor, MI 48103-6560 - Phone
- (734) 707-7736
- NPI assigned
- Jun 29, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301019137 | MI | |
| Psychologist | 103T00000X | 6351004399 | MI | Primary |
Addresses
Primary practice location
2610 W Liberty St
Ann Arbor, MI 48103-6560
Mailing address
2610 W Liberty St
Ann Arbor, MI 48103-6560
Phone (734) 707-7736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 27, 2025 through Feb 27, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6351004399 | MI | MD | Psychologist |
| 6301019137 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657843200000",
"number": "1306331517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2610 W LIBERTY ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481036560",
"telephone_number": "734-707-7736"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2610 W LIBERTY ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481036560",
"telephone_number": "734-707-7736"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHOLANDER",
"first_name": "LARSON",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-29",
"last_updated": "2022-07-15",
"certification_date": "2022-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301019137",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6351004399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.