Individual provider Active NPI

Larnessa Dallas, CPRP, MHP,AAS

  • Rehabilitation Practitioner
  • Bel Air, MD
National Provider Identifier
1821545203
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
47-1223781 Issued in MD
Practice address
734 Hickory Limb Cir
Bel Air, MD 21014-1898
Phone
(302) 331-4551
Fax
(443) 371-7667
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Counselor 225C00000X 47-1223781 MD
Mental Health Counselor 101YM0800X 47-1223781 MD
Case Manager/Care Coordinator 171M00000X 47-1223781 MD
Rehabilitation Practitioner 225400000X 47-1223781 MD Primary

Addresses

Primary practice location

734 Hickory Limb Cir
Bel Air, MD 21014-1898

Mailing address

734 Hickory Limb Cir
Bel Air, MD 21014-1898
Phone (302) 331-4551

Other identifiers 1

IdentifierTypeStateIssuer
47-1223781OtherMDIRS

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
Credentials
Associate of Applied Science

State licenses

LicenseStateTypeSpecialty
47-1223781MDMDRehabilitation Counselor

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1821545203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 HICKORY LIMB CIR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210141898",
            "telephone_number": "302-331-4551",
            "fax_number": "443-371-7667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "734 HICKORY LIMB CIR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210141898",
            "telephone_number": "302-331-4551",
            "fax_number": "443-371-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "LARNESSA",
        "credential": "CPRP, MHP,AAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "MD",
            "license": "47-1223781",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "47-1223781",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "MD",
            "license": "47-1223781",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "MD",
            "license": "47-1223781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS",
            "identifier": "47-1223781",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.