Individual provider Active NPI

Caitlin Larson

  • Behavior Technician
  • Silverdale, WA
National Provider Identifier
1720495377
Registry record updated Jul 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
CB60981733 Issued in WA
Practice address
3100 NW Bucklin Hill Rd Ste 224
Silverdale, WA 98383-8365
Phone
(360) 536-3060
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X
Counselor 101Y00000X CG 60439543 WA
Behavior Technician 106S00000X CB60981733 WA Primary

Addresses

Primary practice location

3100 NW Bucklin Hill Rd Ste 224
Silverdale, WA 98383-8365

Mailing address

13923 S Haystack Peak Cir
Riverton, UT 84096-6453

Other practice location 1

13923 S Haystack Peak Cir
Riverton, UT 84096-6453
Phone (801) 506-6695

Other names 1

  • Caitlin Egan Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clarson@milesaba.org Direct

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

LicenseStateTypeSpecialty
CG 60439543WAMDCounselor
CB60981733WAMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1720495377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13923 S HAYSTACK PEAK CIR",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840966453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 NW BUCKLIN HILL RD STE 224",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838365",
            "telephone_number": "360-536-3060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13923 S Haystack Peak Cir",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840966453",
            "country_code": "US",
            "telephone_number": "801-506-6695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "CAITLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "CG 60439543",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "WA",
            "license": "CB60981733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clarson@milesaba.org",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "3100 NW Bucklin Hill Rd Ste 224",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983838365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CAITLIN",
            "last_name": "EGAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.