Organization Active NPI

Larlo Behavioral Services, PLLC

  • Clinical Neuropsychologist
  • San Antonio, TX
National Provider Identifier
1497397236
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
Legal business name
LARLO BEHAVIORAL SERVICES, PLLC
Practice address
18834 Stone Oak Pkwy Ste 104
San Antonio, TX 78258-4177
Phone
(210) 468-7476
NPI assigned
Oct 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
Abraham LopezNPI 1548747728
Title
PSYD
Phone
(915) 412-8751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103G00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X

Addresses

Primary practice location

18834 Stone Oak Pkwy Ste 104
San Antonio, TX 78258-4177

Mailing address

210 E Sonterra Blvd Apt 624
San Antonio, TX 78258-3955
Phone (915) 242-9378

Other identifiers 1

IdentifierTypeStateIssuer
2224139OtherTXCOMPSYCH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@larlobehavioral.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220329002339 TX Part B Supplier - Clinic/Group Practice 6608262720 Receives reassigned benefits from 1 practitioner
Practice locations: El Paso, TX

National Provider Directory

National Provider Directory

Locations

444 Executive Center Blvd
Ste 126
El Paso, TX 79902
Phone (915) 266-9797

225 E Sonterra Blvd
Ste 111
San Antonio, TX 78258
Phone (210) 993-1876

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1497397236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E SONTERRA BLVD APT 624",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782583955",
            "telephone_number": "915-242-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18834 STONE OAK PKWY STE 104",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584177",
            "telephone_number": "210-468-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARLO BEHAVIORAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "PSYD",
        "authorized_official_telephone_number": "915-412-8751"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "2224139",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@larlobehavioral.com",
            "affiliation": "N",
            "address_1": "18834 Stone Oak Pkwy Ste 104",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782584177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Apr 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.