Individual provider Active NPI

Larissa K Ruuskanen, PSY.D.

  • Clinical Psychologist
  • Fredericksburg, VA
National Provider Identifier
1447558473
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810003829 Issued in VA
Practice address
2217 Princess Anne St Ste 325
Fredericksburg, VA 22401-3358
Phone
(540) 412-8275
NPI assigned
Feb 28, 2011
Last updated
Jul 29, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 0810003829 VA
Clinical Psychologist 103TC0700X 0810003829 VA Primary
Group Psychotherapy Psychologist 103TP2701X 0810003829 VA

Addresses

Primary practice location

2217 Princess Anne St Ste 325
Fredericksburg, VA 22401-3358

Mailing address

2217 Princess Anne St Ste 325
Fredericksburg, VA 22401-3358
Phone (540) 412-8275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20131014001082 VA Practitioner - Clinical Psychologist 4981838513 Practice locations: Fredericksburg, VA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2217 Princess Anne St
Suite 325
Fredericksburg, VA 22401-3358
Phone (540) 412-8275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0810003829VAMDGroup Psychotherapy Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Larissa K. Ruuskanen, Psy.D., LLC Psychologist CurrentSince Aug 2, 2013 Accepting new patients

Locations

2217 Princess Anne St
Ste 325
Fredericksburg, VA 22401
Phone (540) 369-3549

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1298851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1447558473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 PRINCESS ANNE ST STE 325",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013358",
            "telephone_number": "540-412-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 PRINCESS ANNE ST STE 325",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013358",
            "telephone_number": "540-412-8275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUUSKANEN",
        "first_name": "LARISSA",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-28",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VA",
            "license": "0810003829",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810003829",
            "primary": true
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "VA",
            "license": "0810003829",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.