Tanja Eve Larsen, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

005018 Issued in CT

Practice address

317 N Main St
Manchester, CT 06042-2007

Phone

(860) 643-2101

Fax

(860) 645-1470

NPI assigned

Sep 25, 2006

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 CT

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

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.

• Community Child Guidance Clinic, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Manchester, CT
  • NPI 1780730267
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609977685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422007",
            "telephone_number": "860-643-2101",
            "fax_number": "860-645-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060422007",
            "telephone_number": "860-643-2101",
            "fax_number": "860-645-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "TANJA",
        "middle_name": "EVE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "005018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Michael Laperche, MD
• Vincent Nicholas Laporta, DMD
• Angela Larabie
• Joseph William Laro, DMD
• Kenneth Michael Laro, DMD
• Laser and Vision Surgery Center, LLC
• Laureen Forgione Rubino, M.D., LLC
• Andrew Lauzier, APRN
• Grace C Lavallee
• Amanda Lavigne

• Clinical Social Worker in Manchester, CT
• Providers in Manchester, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.