Individual provider Active NPI

Larissa Krause, MSW, ASW

  • Clinical Social Worker
  • Eureka, CA
National Provider Identifier
1851884688
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
67821 Issued in CA
Practice address
2313 I St
Eureka, CA 95501-4244
Phone
(707) 296-9295
NPI assigned
Jun 6, 2018
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 67821 CA Primary

Addresses

Primary practice location

2313 I St
Eureka, CA 95501-4244

Mailing address

2313 I St
Eureka, CA 95501-4244
Phone (707) 296-9295

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210630003997 CA Practitioner - Clinical Social Worker 0042611857 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100011CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Humboldt Neurohealth Therapeutic Services Clinical CurrentSince Mar 3, 2021 Accepting new patients
Humboldt Neurohealth Therapeutic Services PastSince Mar 3, 2021 Accepting new patients

Locations

2145 Myrtle Ave
Eureka, CA 95501
Phone (707) 296-9295

2313 I St
Eureka, CA 95501
Phone (707) 296-9295

3429 Renner Dr
Fortuna, CA 95540
Phone (707) 296-9295

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1851884688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 I ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014244",
            "telephone_number": "707-296-9295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 I ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014244",
            "telephone_number": "707-296-9295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAUSE",
        "first_name": "LARISSA",
        "credential": "MSW, ASW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "67821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.