Active NPI
Todd S Larsen, PH.D.
- Clinical Psychologist
- San Antonio, TX
National Provider Identifier
1477650711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 23132
- Practice address
- 7272 Wurzbach Rd
Suite 1504
San Antonio, TX 78240-4801 - Phone
- (210) 522-1187
- Fax
- (210) 647-7805
- NPI assigned
- Sep 20, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 23132 | TX | Primary |
Addresses
Primary practice location
7272 Wurzbach Rd
Suite 1504
San Antonio, TX 78240-4801
Mailing address
7272 Wurzbach Rd
Suite 1504
San Antonio, TX 78240-4801
Phone (210) 522-1187
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A06L | Other | TX | BLUE CROSS/BLUE SHIELD |
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 |
|---|---|---|---|
| 23132 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477650711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7272 WURZBACH RD",
"address_2": "SUITE 1504",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404801",
"telephone_number": "210-522-1187",
"fax_number": "210-647-7805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7272 WURZBACH RD",
"address_2": "SUITE 1504",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782404801",
"telephone_number": "210-522-1187",
"fax_number": "210-647-7805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "TODD",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "23132",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "00A06L",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.