Brad Walter Larsen, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2269 Issued in OR

Practice address

3050 SE Division St Ste 215
Portland, OR 97202-1451

Phone

(503) 715-5468

Fax

(503) 715-5469

NPI assigned

Sep 24, 2008

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 names 1

• Dr. Brad Walter Larsen Sanchez Former name

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Larsen Sanchez Psychology LLCGroup PAC ID 6608138383, 17 clinicians

Practice addresses (Care Compare)

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.

• Larsen Sanchez Psychology, LLC

  • Clinical Psychologist
  • Portland, OR
  • NPI 1588041388
  Medicare reassignment Care Compare group Authorized official
• Portland Neurofeedback, LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1558875476
  NPD (past)

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689120000000",
    "number": "1679723845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 SE DIVISION ST STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021451",
            "telephone_number": "503-715-5468",
            "fax_number": "503-715-5469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 SE DIVISION ST STE 215",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021451",
            "telephone_number": "503-715-5468",
            "fax_number": "503-715-5469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "BRAD",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2269",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OR",
            "license": "2269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "LARSEN SANCHEZ",
            "middle_name": "WALTER",
            "prefix": "DR.",
            "credential": "PSYD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adrian Larsen Sanchez, PSY.D.
• Andrea Lynn Larsen, MA, LPC
• Annik Larsen, LCSW
• Ashley Alice Larsen
• Ashlin Bixby Larsen, MD
• Brandon H Larsen, FNP, RN
• Christine E. Larsen, MPA
• David Larsen, MD
• Elizabeth Larsen, MACOM, LAC
• Greg Christian Larsen, M.D.

• Psychologist in Portland, OR
• Providers in Portland, OR by specialty
• Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.