Claudette M Larson, LICSW
Individual provider Active NPI Social Worker · Benson, MN
NPI 1306984497 · NPPES record last updated Sep 13, 2011
Key facts
- NPI
- 1306984497
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 16765 (MN)
- Practice address
- 640 Atlantic Ave
Benson, MN 56215 - Phone
- (320) 843-3454
- NPI assigned
- Feb 2, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Willow Creek Counseling LLC
Practice addresses (Care Compare)
14 4TH Ave SE
New London, MN 56273-9558
Phone (320) 354-4200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070523000632 | MN | Practitioner - Clinical Social Worker | 2769589886 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16765 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willow Creek Counseling LLC | Clinical | Current |
Accepting new patients |
| Swift County Benson Hospital | Current |
Accepting new patients | |
| Swift County-Benson Hospital | Current |
Accepting new patients | |
| Community Drug & Alcohol Services Inc | Past | Accepting new patients | |
| Community Drug & Alcohol Services Inc | Social Worker | Past | Accepting new patients |
Locations
1815 Wisconsin Ave
Benson, MN 56215
Phone (320) 843-3454
14 4th Ave SE
New London, MN 56273
Phone (320) 354-4200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16765 | MN | |
| Social Worker | 104100000X | 16765 | MN | Yes |
Addresses
Primary practice location
640 Atlantic Ave
Benson, MN 56215
Mailing address
640 Atlantic Avenue
Benson, MN 56215
Phone (320) 843-3454
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 411910086 | Other | MN | CORP HEALTH |
| 600074381 | Other | MN | MAGELLAN |
| 1050870 | Other | MN | BHP PREFERRED ONE |
| 046D1CA | Other | MN | BCBS |
| 76660100 | Medicaid | MN | |
| HP78786 | Other | MN | HEALTH PARTNERS |
| 152193 | Other | MN | UCARE |
| 6984497 | Other | MN | UBH |
Other names
- Mrs. Claudette M Carlson-Larson
Other providers in Benson, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.