Kerrie Jo Larsonkerkman, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

2153-132 Issued in WI

Practice address

1531 S Madison St
Appleton, WI 54915-1800

Phone

(920) 738-2000

NPI assigned

Oct 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550188800000",
    "number": "1407045966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 JEWELERS PARK DR STE 200",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549563893",
            "telephone_number": "920-205-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1531 S MADISON ST",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151800",
            "telephone_number": "920-738-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSONKERKMAN",
        "first_name": "KERRIE",
        "middle_name": "JO",
        "credential": "CSAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2019-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "2153-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Larson
• John P Larson, PT
• Kirsten W Larson, MD
• Olivia Larson, PHD
• Samantha N Larson, LCSW
• Thomas J. Laselle, DDS
• Allen R Last, MD
• Ilse Lathrop, MS, CCC-SLP
• Bradley L Lauderdale
• Victoria Laurent, DDS

• Addiction (Substance Use Disorder) Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.