Andrea Susan Larsen, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0120 Issued in MN

Practice address

430 Oak Grove Suite #230
Loring Park Office Building
Minneapolis, MN 55403-3253

Phone

(612) 870-0230

Fax

(612) 872-9170

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 10, 2015 through Aug 10, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Counseling and Stressmanagement

  • Clinic/Center
  • Minneapolis, MN
  • NPI 1811225808
  NPD (past)
• Lani T. Bennett, PH. , P.a.

  • Psychologist
  • Minneapolis, MN
  • NPI 1083858450
  NPD (past)
• Maria D. Milillo, PH.D. PA

  • Psychologist
  • Minneapolis, MN
  • NPI 1922285196
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811050248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 OAK GROVE SUITE #230",
            "address_2": "LORING PARK OFFICE BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033253",
            "telephone_number": "612-870-0230",
            "fax_number": "612-872-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 OAK GROVE SUITE #230",
            "address_2": "LORING PARK OFFICE BUILDING",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033253",
            "telephone_number": "612-870-0230",
            "fax_number": "612-872-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "ANDREA",
        "middle_name": "SUSAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1082",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "0120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "59681LA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connor D Laroque
• Ann Laros, MD
• Kate Larose, LPN
• Caroline Laroy, DDS
• Larry Anderson PSYD LLC
• Brian D. Larsen, MD
• Catherine Larsen, LMFT
• Christopher Larsen, RN
• Darian Larsen, LICSW
• Elizabeth Joyceann Larsen, OTR/L

• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.