Active NPI
Kimberly M Larsen-Krugman, LMHC, CASAC
- Mental Health Counselor
- Smithtown, NY
National Provider Identifier
1700152295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 005102
- Practice address
- 21 Redwood LN
Smithtown, NY 11787-2718 - Phone
- (631) 780-5752
- NPI assigned
- Mar 28, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 005102 | NY | Primary |
Addresses
Primary practice location
21 Redwood LN
Smithtown, NY 11787-2718
Mailing address
21 Redwood LN
Smithtown, NY 11787-2718
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 |
|---|---|---|---|
| 005102 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411603200000",
"number": "1700152295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 REDWOOD LN",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 REDWOOD LN",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117872718",
"telephone_number": "631-780-5752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN-KRUGMAN",
"first_name": "KIMBERLY",
"middle_name": "M",
"name_prefix": "Prof.",
"credential": "LMHC, CASAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-28",
"last_updated": "2014-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "005102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.