Samuel W Larson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3698 Issued in TN

Practice address

2200 21St Ave S Ste 300
Nashville, TN 37212-4929

Phone

(615) 933-3571

NPI assigned

Sep 9, 2015

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Jacqueline Klaver PHD, PLLC

  dba Nashville Neuropsychology & Family Services

  • Clinical Neuropsychologist
  • Nashville, TN
  • NPI 1902327976
  NPD

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581379200000",
    "number": "1699143677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819A SHACKLEFORD RD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372153525",
            "telephone_number": "773-351-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 21ST AVE S STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372124929",
            "telephone_number": "615-933-3571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Warren St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021353602",
            "country_code": "US",
            "telephone_number": "617-254-3800 x1261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "SAMUEL",
        "middle_name": "W",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "3698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Larson, PA-C
• Heather B Larson, CRNA
• Karen E Larson, M.D.
• Katherine Larson, MMFT
• Leila Larson, PT
• Summer Nicole Larson, PHARMD
• Paolette Larue, APRN
• Richard W Larue Jr., MD
• Las Vegas Iom LLC
• Melissa Kent Lasater, ACNP-BC

• Clinical Psychologist in Nashville, TN
• Providers in Nashville, TN by specialty
• Clinical Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; 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.