Active NPI
Devan Larsen, LMFT-I
- Marriage & Family Therapist
- Bend, OR
National Provider Identifier
1700402070
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- R6321
- Practice address
- 20526 Mutt CT
Bend, OR 97701-7935 - Phone
- (714) 478-3288
- NPI assigned
- Jun 22, 2020
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | R6321 | OR | Primary |
Addresses
Primary practice location
20526 Mutt CT
Bend, OR 97701-7935
Mailing address
20526 Mutt CT
Bend, OR 97701-7935
Phone (714) 478-3288
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 |
|---|---|---|---|
| R6321 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592784000000",
"number": "1700402070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20526 MUTT CT",
"city": "BEND",
"state": "OR",
"postal_code": "977017935",
"telephone_number": "714-478-3288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20526 MUTT CT",
"city": "BEND",
"state": "OR",
"postal_code": "977017935",
"telephone_number": "714-478-3288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSEN",
"first_name": "DEVAN",
"credential": "LMFT-I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-22",
"last_updated": "2020-06-22",
"certification_date": "2020-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "R6321",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.