Larissa Rose Wolford, M.A., LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47710 Issued in CA

Practice address

1683 Novato Blvd Ste 8
Novato, CA 94947-3284

Phone

(415) 609-4077

NPI assigned

Oct 25, 2011

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Professional

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452297600000",
    "number": "1386920189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 NOVATO BLVD STE 8",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473284",
            "telephone_number": "415-609-4077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1683 NOVATO BLVD STE 8",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949473284",
            "telephone_number": "415-609-4077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "LARISSA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2016-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47710",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "1065",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "CA",
            "license": "140082874",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13678958",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cory Aaron Willson
• Diana Lynne Wilson, MFT
• Donald Lewis Wilson, DDS, MSD
• Robert L Wirth, M.D.
• Ariane Wlasak, DAOM, L.AC.
• Carmen W Wong
• Katrina A. Woo Cabarrus, M.D.
• Betty S. Wood, LCSW
• Ping Wu, P.T.
• Tianyun Wu, PH.D.

• Marriage & Family Therapist in Novato, CA
• Providers in Novato, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.