Corrie Lee Larson, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW60324692 Issued in WA

Practice address

650 Joel Dr
Fort Campbell, KY 42223-5318

Phone

(270) 798-8400

NPI assigned

Apr 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Corrie Lee Kelley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Bloom Counseling & Consultation

  • Adult Mental Health Clinic/Center
  • Clarksville, TN
  • NPI 1467268045
  NPD Authorized official

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

{
    "created_epoch": "1333584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1487910246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-403-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CORRIE",
        "middle_name": "LEE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-05",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW60324692",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORRIE",
            "last_name": "KELLEY",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher Lee Lange, M.D.
• Jennifer Travis Lange, M.D.
• Alexander Lanigan, M.D.
• Carleen Frances Laplant, DPT, ATC, CSCS, TSAC
• Maura Lappin, D.O.
• Mary Joanne Laurin, LPT
• David G. Lavelle, PHYSICIAN ASSISTANT
• John H Law, DDS, MS
• Kristen Lawatsch, PHARM.D.
• David G. Lawton, D.O.

• Clinical Social Worker in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.