Individual provider Active NPI

Dylan M Larson-Konar, PHD

  • Psychologist
  • Denver, CO
National Provider Identifier
1558099028
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6189 Issued in CO
Practice address
950 N Logan St Ste 101
Denver, CO 80203-3186
Phone
(303) 834-1026
NPI assigned
Aug 11, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6189 CO Primary

Addresses

Primary practice location

950 N Logan St Ste 101
Denver, CO 80203-3186

Mailing address

1630 N Clarkson St Apt 502
Denver, CO 80218-1482
Phone (515) 450-9061

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

LicenseStateTypeSpecialty
6189COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dylan Larson-Konar LLC Psychologist Current Accepting new patients
Badwan Psychology PLLC CurrentSince Aug 14, 2022 Accepting new patients

Locations

950 N Logan St
Ste 101
Denver, CO 80203
Phone (303) 355-6682

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1558099028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 N CLARKSON ST APT 502",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802181482",
            "telephone_number": "515-450-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N LOGAN ST STE 101",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802033186",
            "telephone_number": "303-834-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON-KONAR",
        "first_name": "DYLAN",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2024-01-25",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "6189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.