Individual provider Active NPI

Beth Ann Larsen, LCSW

  • Social Worker
  • Austin, TX
National Provider Identifier
1619079258
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
14216 Issued in TX
Practice address
314 E. Highland Mall Boulevard
Suite 401
Austin, TX 78752
Phone
(512) 923-2384
Fax
(512) 628-6908
NPI assigned
Sep 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14216 TX
Social Worker 104100000X 14216 TX Primary

Addresses

Primary practice location

314 E. Highland Mall Boulevard
Suite 401
Austin, TX 78752

Mailing address

314 E. Highland Mall Boulevard
Suite 401
Austin, TX 78752
Phone (512) 923-2384

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
14216TXMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1619079258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 E. HIGHLAND MALL BOULEVARD",
            "address_2": "SUITE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78752",
            "telephone_number": "512-923-2384",
            "fax_number": "512-628-6908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E. HIGHLAND MALL BOULEVARD",
            "address_2": "SUITE 401",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78752",
            "telephone_number": "512-923-2384",
            "fax_number": "512-628-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "14216",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TX",
            "license": "14216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.