Nicole Elizabeth Larson, MSW, LICSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

21088 Issued in MN

Practice address

101 5TH St E Ste 207
Northfield, MN 55057-2076

Phone

(507) 301-6741

Fax

(507) 517-3492

NPI assigned

Oct 24, 2012

Last updated

Jan 3, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicole Larson LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Northfield, MN
  • NPI 1477221075
  Medicare reassignment NPD Authorized official
• MN Mental Health Consulting LLC

  • Community/Behavioral Health Agency
  • Edina, MN
  • NPI 1639343783
  NPD (past)

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1568715803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 5TH ST E STE 207",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572076",
            "telephone_number": "507-301-6741",
            "fax_number": "507-517-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 5TH ST E STE 207",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550572076",
            "telephone_number": "507-301-6741",
            "fax_number": "507-517-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "NICOLE",
        "middle_name": "ELIZABETH",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-24",
        "last_updated": "2022-01-03",
        "certification_date": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "21088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirstin E Kuchler, SLP
• Mark E Labenski, MD
• Megan Langhoff, M. ED., LGSW
• Gwynevere Abigail Larson-McCluskey
• Krista M Larson, MSW, LICSW
• Katherine Ann Lathrop
• Shannon Theresa Lau, MD
• Laura Baker School Association (Laura Baker Services Association)
• Shaele Leach
• Claire Crandall Leduc, RN, APRN, CRNA

• Social Worker in Northfield, MN
• Providers in Northfield, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.