Active NPI
David Larson, L.P.
- Counseling Psychologist
- Albert Lea, MN
National Provider Identifier
1316048770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP0618
- Practice address
- 244 W Clark St
Albert Lea, MN 56007-2548 - Phone
- (507) 373-7913
- Fax
- (507) 373-7913
- NPI assigned
- Sep 26, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP0618 | MN | Primary |
Addresses
Primary practice location
244 W Clark St
Albert Lea, MN 56007-2548
Mailing address
244 W Clark St
Albert Lea, MN 56007-2548
Phone (507) 373-7913
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 411805759 | Other | MN | BHP |
| 103748000 | Medicaid | MN | |
| 115228 | Other | MN | UCARE AND SCHA |
| 30235LA | Other | MN | BCBS |
| 99099 | Other | MN | PREFERRED ONE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LP0618 | MN | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Institute for Wellness | Counseling | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counseling Psychologist
- Albert Lea, MN
- NPI 1982920609
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271635200000",
"number": "1316048770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "244 W CLARK ST",
"city": "ALBERT LEA",
"state": "MN",
"postal_code": "560072548",
"telephone_number": "507-373-7913",
"fax_number": "507-373-7913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "244 W CLARK ST",
"city": "ALBERT LEA",
"state": "MN",
"postal_code": "560072548",
"telephone_number": "507-373-7913",
"fax_number": "507-373-7913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "DAVID",
"credential": "L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2010-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP0618",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHP",
"identifier": "411805759",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "103748000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE AND SCHA",
"identifier": "115228",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "30235LA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "99099",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albert Lea, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.