Matthew Paul Larson, CADC, RYT200

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

37495 Issued in IL

Practice address

41W400 Silver Glen Rd
St Charles, IL 60175-8453

Phone

(630) 940-1193

NPI assigned

Sep 27, 2023

Last updated

Sep 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1437938537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41W400 SILVER GLEN RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601758453",
            "telephone_number": "630-940-1193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41W400 SILVER GLEN RD",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601758453",
            "telephone_number": "630-940-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "MATTHEW",
        "middle_name": "PAUL",
        "credential": "CADC, RYT200",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "37495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Lange, CF-SLP
• Susan Marie Lange, OTRL
• Herman Paul Langner, M.D.
• Jeffrey Gerard Larson
• Laura Elizabeth Larson, LCSW
• Lara Lasky, MPH, CD
• Nicholas G. Lattanzio, PSYD
• Connor Lavallie, DC
• Natalia Elizabeth Lavallie, DC
• Chloe Le

• Addiction (Substance Use Disorder) Counselor in St Charles, IL
• Providers in St Charles, IL by specialty
• Addiction (Substance Use Disorder) Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.