Active NPI
Kris Eric Larsen, LCPC
- Professional Counselor
- Chicago, IL
National Provider Identifier
1629595129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 180-003026
- Practice address
- 2140 W Lunt Ave
Chicago, IL 60645-4816 - Phone
- (312) 405-9475
- NPI assigned
- Aug 25, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 180-003026 | IL | Primary |
Addresses
Primary practice location
2140 W Lunt Ave
Chicago, IL 60645-4816
Mailing address
2140 W Lunt Ave
Chicago, IL 60645-4816
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 180-003026 | IL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503619200000",
"number": "1629595129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2140 W LUNT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606454816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2140 W LUNT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606454816",
"telephone_number": "312-405-9475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "KRIS",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-25",
"last_updated": "2017-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "IL",
"license": "180-003026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.