Kimberly Larsen, LAC CADAC V

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

86000384A Issued in IN

Practice address

612 W Morgan Ave
Chesterton, IN 46304-2244

Phone

(219) 307-0086

NPI assigned

Feb 16, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1588257976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W MORGAN AVE",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042244",
            "telephone_number": "219-307-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W MORGAN AVE",
            "city": "CHESTERTON",
            "state": "IN",
            "postal_code": "463042244",
            "telephone_number": "219-307-0086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "KIMBERLY",
        "credential": "LAC   CADAC V",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "86000384A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Anne Lambert, M.S
• Lindsay Lardino, DPT
• Rachel Lawrenz
• Cassie R Layne, FNP
• Lee Ann M. Leady, NP
• April C Leddell-Hughes, D.P.M.
• Tara Lehmann, MSOT, OTR/L

• Addiction (Substance Use Disorder) Counselor in Chesterton, IN
• Providers in Chesterton, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.