Philip Reed Larsen Jr., LICSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C-09948 Issued in NM

Practice address

1229 S Saint Francis Dr Ste B
Santa Fe, NM 87505-4052

Phone

(413) 626-1094

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Servicenet Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northampton, MA
  • NPI 1659314425
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1497781496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2139",
            "city": "SANTA CRUZ",
            "state": "NM",
            "postal_code": "875672139",
            "telephone_number": "413-626-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 S SAINT FRANCIS DR STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054052",
            "telephone_number": "413-626-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "PHILIP",
        "middle_name": "REED",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LICSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "C-09948",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramon A Larranaga Jr., ACT CM
• Larry F Widmer DC LLC
• Larry L Cohen MD, PC
• Larry Rayburn Psychotherapy
• Madeleine Fisher Larsen
• Robert Charles Larsen, MD
• Las Clinicas del Norte Incorporated
• Las Clinicas del Norte Incorporated
• Ann F Laser, LPC LMFT
• Christin Shivani Lash, CPM LM

• Clinical Social Worker in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Clinical Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.