Active NPI
Eric Larsson, P.H.D, L.P.
- Cognitive & Behavioral Psychologist
- Minneapolis, MN
National Provider Identifier
1447338702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- LP1531
- Practice address
- 2925 Dean Pkwy
Suite 300
Minneapolis, MN 55416-4470 - Phone
- (612) 925-8365
- Fax
- (612) 925-8366
- NPI assigned
- Nov 2, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | LP1531 | MN | Primary |
| Clinical Psychologist | 103TC0700X | LP1531 | MN |
Addresses
Primary practice location
2925 Dean Pkwy
Suite 300
Minneapolis, MN 55416-4470
Mailing address
2925 Dean Pkwy
Suite 300
Minneapolis, MN 55416-4470
Phone (612) 925-8365
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0638K3LA | Other | MN | BCBS OF MN |
| 688548900 | Medicaid | MN |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1531 | MN | MD | Cognitive & Behavioral Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lovaas Institute for Early Intervention - Midwest, Inc. | Clinical | 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.
-
- Community/Behavioral Health Agency
- Bloomington, MN
- NPI 1487732764
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460419200000",
"number": "1447338702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2925 DEAN PKWY",
"address_2": "SUITE 300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164470",
"telephone_number": "612-925-8365",
"fax_number": "612-925-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2925 DEAN PKWY",
"address_2": "SUITE 300",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164470",
"telephone_number": "612-925-8365",
"fax_number": "612-925-8366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSSON",
"first_name": "ERIC",
"name_prefix": "Dr.",
"credential": "P.H.D, L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-02",
"last_updated": "2016-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "MN",
"license": "LP1531",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1531",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MN",
"identifier": "0638K3LA",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "688548900",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.