Active NPI
Laureen Marie Larrison, LPC
- Professional Counselor
- Wausau, WI
National Provider Identifier
1750391496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3017-125
- Practice address
- 705 S 24TH Ave Ste 402
Wausau, WI 54401-5242 - Phone
- (715) 848-1457
- Fax
- (715) 848-2959
- NPI assigned
- Aug 8, 2006
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3017-125 | WI | Primary |
Addresses
Primary practice location
705 S 24TH Ave Ste 402
Wausau, WI 54401-5242
Mailing address
1090 Evans St
Waupaca, WI 54981-2034
Phone (715) 258-2634
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39787400 | Medicaid | WI | |
| 3017-125 | Other | WI | LPC STATE LICENSE |
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 |
|---|---|---|---|
| 3017-125 | WI | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1750391496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1090 EVANS ST",
"city": "WAUPACA",
"state": "WI",
"postal_code": "549812034",
"telephone_number": "715-258-2634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S 24TH AVE STE 402",
"city": "WAUSAU",
"state": "WI",
"postal_code": "544015242",
"telephone_number": "715-848-1457",
"fax_number": "715-848-2959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARRISON",
"first_name": "LAUREEN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "WI",
"license": "3017-125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39787400",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC STATE LICENSE",
"identifier": "3017-125",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wausau, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.