Kerry Larson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018521 Issued in IL

Practice address

3815 Harrison Ave
Rockford, IL 61108-7631

Phone

(815) 391-1000

Fax

(815) 391-5040

NPI assigned

Nov 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1588177398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 N MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611073877",
            "telephone_number": "815-387-5600",
            "fax_number": "815-316-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 HARRISON AVE",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611087631",
            "telephone_number": "815-391-1000",
            "fax_number": "815-391-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611087631",
            "country_code": "US",
            "telephone_number": "815-391-1000",
            "fax_number": "815-391-5040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "149018521",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Lapier, PT
• Christine Elizabeth Larson, PA
• David Darrell Larson, DMD
• Kathleen A. Larson, O.T.
• Kelley Nicole Larson, LSW
• Lisa A. Larson, APRN
• Mae Marie Larson
• Mary S Larson
• Robert A Larson, DO
• Katelynn Larue, PA-C

• Clinical Social Worker in Rockford, IL
• Providers in Rockford, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.