Kymberly Larson, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

071.008752 Issued in IL

Practice address

2100 Manchester Rd
Suite 1510
Wheaton, IL 60187-4579

Phone

(630) 653-1717

Fax

(630) 653-9691

NPI assigned

Jan 21, 2014

Last updated

Jan 21, 2014By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Marvelous Minds, Inc

  • Mental Health Counselor
  • Glen Ellyn, IL
  • NPI 1902319916

  Clinical Neuropsychologist

  NPD Authorized official

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390262400000",
    "number": "1629491097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD",
            "address_2": "SUITE 1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-653-1717",
            "fax_number": "630-653-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MANCHESTER RD",
            "address_2": "SUITE 1510",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601874579",
            "telephone_number": "630-653-1717",
            "fax_number": "630-653-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "KYMBERLY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2014-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "IL",
            "license": "071.008752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Yasmin Larimore, MA, LCPC
• Jane Elizabeth Larsen, M.D
• Kelly J Larsen, LCPC
• Beth E Larson, MD
• Cassidy Lee Larson
• Richard Girard Larson Jr., LCPC
• Ashley Laskowski
• Karen Latrofa
• Jaclyn A Lauderback, OTR/L
• Shannon Nicole Lauf, PMHNP-BC

• Clinical Neuropsychologist in Wheaton, IL
• Providers in Wheaton, IL by specialty
• Clinical Neuropsychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.