Active NPI
Nicole A Larsen, LCPC
- Professional Counselor
- Baltimore, MD
National Provider Identifier
1700224763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC5121
- Practice address
- 6103 Parkway Dr
Baltimore, MD 21212-2737 - Phone
- (443) 791-6040
- NPI assigned
- Jun 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | LC5121 | MD | Primary |
Addresses
Primary practice location
6103 Parkway Dr
Baltimore, MD 21212-2737
Mailing address
6103 Parkway Dr
Baltimore, MD 21212-2737
Phone (443) 791-6040
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 |
|---|---|---|---|
| LC5121 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370908800000",
"number": "1700224763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6103 PARKWAY DR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212122737",
"telephone_number": "443-791-6040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6103 PARKWAY DR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212122737",
"telephone_number": "443-791-6040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "NICOLE",
"middle_name": "A",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-11",
"last_updated": "2013-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC5121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.