Active NPI
Gillian Larue, PSYD
- Clinical Psychologist
- Murfreesboro, TN
National Provider Identifier
1336654524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 5949
- Practice address
- 260 Glenis Dr
Murfreesboro, TN 37129-5102 - Phone
- (615) 997-6159
- NPI assigned
- Dec 10, 2017
- Reactivated
- Oct 5, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 5949 | NC | Primary |
Addresses
Primary practice location
260 Glenis Dr
Murfreesboro, TN 37129-5102
Mailing address
PO Box 58313
Nashville, TN 37205-8313
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 |
|---|---|---|---|
| 5949 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693958400000",
"number": "1336654524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 58313",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "372058313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "260 GLENIS DR",
"city": "MURFREESBORO",
"state": "TN",
"postal_code": "371295102",
"telephone_number": "615-997-6159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARUE",
"first_name": "GILLIAN",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-10",
"last_updated": "2023-09-06",
"certification_date": "2023-09-06",
"deactivation_date": "2020-01-08",
"reactivation_date": "2021-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "5949",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murfreesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.