Shane Michael Larson, M.S., LPC-MH

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCMH2210 Issued in SD

Practice address

100 S Maple
Suite 204
Watertown, SD 57201-3678

Phone

(605) 520-0157

NPI assigned

Oct 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492992000000",
    "number": "1679655856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1131",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572016131",
            "telephone_number": "605-520-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S MAPLE",
            "address_2": "SUITE 204",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572013678",
            "telephone_number": "605-520-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SHANE",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "M.S., LPC-MH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2017-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SD",
            "license": "LPCMH2210",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5200010",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Renae Larson, BS
• Diantha Jean Larson, CCDC T
• Gregory R. Larson, MD
• Joyce L Larson, PA-C
• Karyl Lee Larson, R. PH.
• Chad Laverne Lauseng, P.T.
• Alan A. Lawrence, MD
• Chala M Lechner, RPT, MS
• Thomas R Lechner, MD
• Lisa A Lee, CNP

• All providers in Watertown, SD
• Professional Counselor in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.